Modifiable cardiovascular disease risk factors as predictors of dementia death: pooling of ten general population-based cohort studies.

G David Batty,Emmanuel Stamatakis,Tom C Russ,Mika Kivimäki,John M Starr

doi:10.1186/1477-5751-13-8

Abstract

BackgroundWith drug treatment for dementia being of limited effectiveness, the role of primary prevention, in particular the predictive value of modifiable cardiovascular disease risk factors, may warrant exploration. The evidence base is, however, characterised by discordant findings and is modest in size. Accordingly, we examined the association of modifiable cardiovascular disease risk factors with dementia death.Design and methodsWe pooled raw data from 10 UK general population-based prospective cohort studies within the context of an individual participant meta-analysis.ResultsA total of 103,764 men and women were followed up for a mean of 8 years giving rise to 443 dementia-related deaths and 2612 cardiovascular disease deaths. Cardiovascular disease mortality was, as anticipated, associated with the full range of risk factors under study, including raised blood pressure, smoking, diabetes, physical inactivity. By contrast, dementia death was related to very few of the cardiovascular disease risk factors: of those classified as modifiable, only smoking was associated with a raised risk and higher levels of non-HDL with a lower risk.ConclusionsIn the present individual participant meta-analysis, there was limited evidence that cardiovascular disease risk factors were related to dementia death.

Highlights

With drug treatment for dementia being of limited effectiveness, the role of primary prevention, in particular the predictive value of modifiable cardiovascular disease risk factors, may warrant exploration
Dementia death was related to very few of the cardiovascular disease risk factors: of those classified as modifiable, only smoking was associated with a raised risk and higher levels of non-HDL with a lower risk
In the present individual participant meta-analysis, there was limited evidence that cardiovascular disease risk factors were related to dementia death

Summary

Introduction

With drug treatment for dementia being of limited effectiveness, the role of primary prevention, in particular the predictive value of modifiable cardiovascular disease risk factors, may warrant exploration. As we have done in different contexts [4,5,6,7], we present a meta-analysis of individual-participant data from ten UK population-based cohort studies Taking this approach involves the pooling of raw data. While the individual participant meta-analysis approach has been taken for physiological risk factors in relation to somatic disease outcomes [8,9], it is much less common in the field of psychiatry. To our knowledge, this is the largest study to date to explore the link between individual CVD risk factors and dementia death and the first individual participant meta-analysis. For the purposes of comparison, we report on the relation of the same collection of risk factors with CVD mortality

Methods

Results

Conclusion