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Heart Risks Tied to Increased Dementia Risks

Having risk factors for heart disease and stroke is associated with brain changes that may predict memory and thinking problems and Alzheimer’s disease years later, according to a new report. The findings add to a growing body of evidence that what’s good for the heart is good for the brain. They also underscore the importance of taking measures, like eating a heart-healthy diet and getting regular exercise, for helping to keep the brain sharp.

“In the absence of effective treatments for dementia, we need to monitor and control cardiovascular risk burden as a way to maintain patient’s cognitive health as they age,” said study author Weili Xu of Tianjin Medical University in China. “Given the progressive increase in the number of dementia cases worldwide, our findings have both clinical and public health relevance.” The study was published in the Journal of the American College of Cardiology.

For the study, researchers looked at 1,588 men and women who were part of the Rush Memory and Aging Project. All were free of dementia at the start of the study, when most were in their 50s or 60s, and they were followed for more than 20 years.

Their heart risks were assessed at the start of the study period, considering risk factors like age, smoking history, total cholesterol levels, levels of HDL “good” cholesterol, and blood pressure. They were grouped into three groups, ranging from the lowest, the middle or the highest risk.

They also got yearly memory assessments to test for memory loss and signs of dementia. Some also had MRI brain scans to measure the volume of various parts of their brains.

The researchers found that the more risk factors they had for cardiovascular disease at the start of the study period, the greater the declines in memory and thinking skills over the next 20 plus years. Most were in their 70s or 80s by the end of the study period.

More cardiovascular risk factors were also linked to greater shrinkage of total brain volume, including gray matter, and especially the hippocampus, an area critical for memory that are also affected by Alzheimer’s disease. A modest degree of brain shrinkage has been linked to a higher risk of Alzheimer’s disease in other studies as well; more serious brain shrinkage is a hallmark of the disease, especially of later stages. Those with more heart risk factors also had a greater number of white matter hyperintensities, abnormal brain changes that are also common in people with dementia.

In earlier studies, high blood pressure, high cholesterol, obesity and diabetes have all been linked to a greater risk of Alzheimer’s disease and other forms of dementia down the road.

“The results of this study suggest a useful tool for assessing dementia risk and support recommendations to aggressively manage cardiovascular risk factors in midlife,” wrote Dr. Costantino Ladecola of Weill Cornell Medicine in an accompanying editorial. He noted that cardiologists and family doctors often cite heart risks to their patients, but fail to mention dementia as a long-term risk for those at high risk for heart disease.

Doctors recommend a variety of measures to maintain heart health, which may also help to ward off dementia. Among them: Keep blood pressure in check and cholesterol levels down. Avoid obesity and other risk factors for poor blood sugar control and diabetes. Try to get regular exercise. Eat a heart-healthy diet, with plenty of fruits and vegetables, fish and “good” fats like olive oil. And don’t smoke.

Regardless of your age, it’s never too early or too late to strive for a lifetime of robust brain health free of dementia.

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Source: Ruixue Song, Hui Xu, Christina S. Dintica, et al: “Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline.” Journal of the American College of Cardiology, Vol. 75, Issue 20, May 18, 2020