Summary: People who suffer from cardiometabolic disorders, such as stroke, diabetes, or heart attack, whether as standalone conditions or a combination of the conditions, have an increased risk of developing dementia, whether they have or not a genetic predisposition to neurodegeneration.
Source: University of Exeter
Having multiple conditions that affect the heart is linked to a greater risk of dementia than having a high genetic risk, according to a new large-scale study.
Led by the University of Oxford and the University of Exeter, the study is one of the largest to ever examine the link between several heart conditions and dementia, and one of the few to look at the complex issue of multiple health problems.
Posted in The healthy longevity of the Lancet, the paper looked at data from over 200,000 people, aged 60 or over, with European ancestry in the UK Biobank. The international research team identified those who had been diagnosed with diabetes, stroke or heart attack, or any combination of the three, and those who developed dementia.
Within this study population, the researchers found that the more a person suffered from these three conditions, the higher their risk of dementia. People with all three conditions were three times more likely to develop dementia than people with a high genetic risk.
Dr Xin You Tai, lead author and PhD student at the University of Oxford, said: “Dementia is a major global problem, with predictions that 135 million people worldwide will suffer from this devastating disease by 2050.
“We found that having such heart conditions is more related to dementia risk than genetic risk. So no matter what genetic risk you were born with, you can potentially have a big impact on reducing dementia risk by taking care of your heart and metabolic health throughout your life.
The team, which included the universities of Glasgow and Michigan, found that nearly 20,000 of the UK biobank participants they studied had been diagnosed with one of three conditions. Just over 2,000 had two conditions and 122 had all three.
Lead author Professor David Llewellyn, Professor of Clinical Epidemiology and Clinical Health at the University of Exeter, said: “Many studies look at the risk of a single disease in relation to dementia, but health is more complex than that. We know that many patients actually have a range of conditions.
“Our study tells us that for people who are diagnosed with diabetes, stroke or heart attack, it is especially important to take care of their health and ensure they are on the right treatment, so prevent further problems and reduce their risk of dementia.”
The team divided the 200,000 participants into three genetic risk categories from top to bottom, based on a comprehensive risk score reflecting several genetic risk traits relevant to people of European ancestry.
They also had brain imaging data for more than 12,000 participants and found widespread damage across the brain for those with more than one cardiometabolic disease. In contrast, high genetic risk was only linked to deterioration in specific parts of the brain.
Study co-author Dr. Kenneth M. Langa, a professor of medicine at the University of Michigan and Ann Arbor Veterans’ Health System, said, “Our research indicates that protecting the heart throughout of life likely has significant benefits for the brain as well. To take care of your heart, you can exercise regularly, eat a healthy diet, and do all you can to keep your blood pressure, blood sugar, and cholesterol levels within guidelines.
Dr Sara Imarisio, Head of Research at Alzheimer’s Research UK, said: “Clearly what is good for your heart is also good for your head. A person’s risk of developing dementia is a complex mix of their age, genes and aspects of their lifestyle. “
In this study, researchers looked at data from a population aged 60 and over, including whether they had any particular heart conditions, information about their genetics, and how these affected their risk of developing dementia.
They found that people with multiple heart conditions were even more likely to develop dementia than people with an increased risk of Alzheimer’s disease due to their genetics.
“These results reiterate the importance of addressing the causes of poor heart health, not only for its own good, but also for the added benefit of reducing the number of cases of dementia. From the generosity of our supporters who allowed us to finance this work, to the altruism of the volunteers who made it possible, we would like to say thank you, without you a research like this cannot take place.
“If anyone is concerned about your heart or brain health, please talk to your doctor.”
The article is entitled “Cardiometabolic multimorbidity, genetic risk and dementia: a prospective cohort study”.
Funding: The study is funded by the Wellcome Trust, Alzheimer’s Research UK, Alan Turing Institute, Engineering and Physical Sciences Research Council, National Institute for Health Research Applied Research Collaboration South West Peninsula, National Health and Medical Research Council, JP Moulton Foundation, and the National Institute on Aging/National Institutes of Health.
About this cardiometabolic health and dementia research news
Author: Louise Vennel
Source: University of Exeter
Contact: Louise Vennells – University of Exeter
Image: Image is in public domain
Original research: Free access.
“Cardiometabolic multimorbidity, genetic risk and dementia: a prospective cohort study” by Xin You Tai et al. Lancet Healthy Longevity
Cardiometabolic multimorbidity, genetic risk and dementia: a prospective cohort study
Individual cardiometabolic disorders and genetic factors are associated with an increased risk of dementia; however, the relationship between dementia and cardiometabolic multimorbidity is unclear. We investigated whether cardiometabolic multimorbidity increases the risk of dementia, regardless of genetic risk, and examined associated brain structural changes.
We examined the health and genetic data of 203,038 UK Biobank participants of European ancestry, aged 60 or older without dementia at baseline (2006-2010) and followed up to March 31, 2021, in England and Scotland and on February 28, 2018, in Wales, as well as brain structural data in a nested imaging subsample of 12,236 participants. A cardiometabolic multimorbidity index including stroke, diabetes and myocardial infarction (one point for each) and a polygenic dementia risk score (with low, intermediate and high risk groups) were calculated for each participant. The primary outcomes were all-cause incident dementia and structural measures of the brain.
The risk of dementia associated with high cardiometabolic multimorbidity was three times higher than that associated with high genetic risk (relative risk [HR] 5 55, 95% CI 3 39–9 08, p<0 0001, and 1 68, 1 53–1 84, p<0 0001, respectively). Participants with both high genetic risk and a cardiometabolic multimorbidity index of two or more had an increased risk of developing dementia (HR 5 74, 95% CI 4 26–7 74, p<0 0001), compared to those at low genetic risk and without cardiometabolic conditions. Importantly, we found no interaction between cardiometabolic multimorbidity and polygenic risk (p=0·18). Cardiometabolic multimorbidity was independently associated with larger and more widespread brain structural changes, including lower hippocampal volume (F2, 12 110= 10 70; p<0 0001) and total gray matter volume (F2, 12,236= 55 65; p<0 0001).
Cardiometabolic multimorbidity was independently associated with dementia risk and widespread brain imaging differences to a greater extent than genetic risk. Targeting cardiometabolic multimorbidity could help reduce the risk of dementia, regardless of genetic risk.
Wellcome Trust, Alzheimer’s Research UK, Alan Turing Institute/Engineering and Physical Sciences Research Council, National Institute for Health Research Applied Research Collaboration South West Peninsula, National Health and Medical Research Council, JP Moulton Foundation and National Institute on Aging/National Institutes of health.
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