Midlife Vascular Risk Factors Tied to Dementia Risk

Vascular risk factors at midlife, including smoking and hypertension, are associated with an increased risk of dementia in later life, according to the results of a recent study.

Previous research has linked vascular risk factors to cognitive decline, but the effects of these risk factors in midlife are not well established.
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For their study, the researchers conducted a prospective cohort investigation of data from the Atherosclerosis Risk in Communities (ARIC) Study, including 15,744 participants aged 44 to 66 years at baseline.

Vascular risk factors, including obesity, smoking, diabetes, prehypertension, hypertension, and hypercholesterolemia, were measured at baseline, as was the presence of the APOE ε4 genotype. Four additional in-person visits were conducted following the baseline visit.

Overall, 1516 cases of dementia were reported. Black race, older age, lower educational attainment, and APOE ε4 genotype were all associated with dementia. Midlife smoking, diabetes, prehypertension, and hypertension were all also associated with dementia later in life. Notably, the hazard ratio for dementia in participants with midlife diabetes was nearly as high as the hazard ratio for dementia in patients with the APOE ε4 genotype.

“Midlife vascular risk factors are associated with increased risk of dementia in black and white ARIC Study participants. Further studies are needed to evaluate the mechanism of and opportunities for prevention of the cognitive sequelae of these risk factors in midlife,” the researchers concluded.

—Michael Potts

Reference:

Gottesman RF, Albert MS, Alonso A, et al. Associations between midlife vascular risk factors and 25-year incident Dementia in the Atherosclerosis Risk in Communities (ARIC) cohort [published online August 7, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.1658.