Can dementia risk be reduced by following the American Heart Association's Life's Simple 7? A systematic review and dose-response meta-analysis

Jing Wu; Ying Xiong; Xin Xia; Nicola Orsini; Chengxuan Qiu; Miia Kivipelto; Debora Rizzuto; Rui Wang

doi:10.1016/j.arr.2022.101788

Can dementia risk be reduced by following the American Heart Association's Life's Simple 7? A systematic review and dose-response meta-analysis

Ageing Res Rev. 2023 Jan:83:101788. doi: 10.1016/j.arr.2022.101788. Epub 2022 Nov 9.

Authors

Jing Wu¹, Ying Xiong², Xin Xia³, Nicola Orsini⁴, Chengxuan Qiu³, Miia Kivipelto⁵, Debora Rizzuto⁶, Rui Wang⁷

Affiliations

¹ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. Electronic address: jing.wu@ki.se.
² Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
³ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
⁴ Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
⁵ Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Theme Aging, Karolinska University Hospital, Sweden.
⁶ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
⁷ Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; The Swedish School of Sport and Health Science, GIH, Stockholm, Sweden; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: rui.wang@gih.se.

PMID: 36371016
DOI: 10.1016/j.arr.2022.101788

Abstract

This study aimed to quantify the relationships between the American Heart Association (AHA) Cardiovascular Health (CVH) metrics, namely AHA Life's Simple 7, and cognitive outcomes. We searched PubMed and Embase (January 1, 2010-August 24, 2022) and finally included 14 longitudinal studies (311654 participants with 8006 incident dementia cases). Random-effects meta-analysis and one-stage linear mixed-effects models were performed. Increased CVH score seemed to associate with decreased risk of incident dementia in a linear manner, but this relationship varied by the measurement age of CVH metrics. That is, midlife CVH tended to have a linear association with late-life dementia risk, whereas a J-shaped association was observed between the late-life CVH score and dementia. In addition, late-life dementia risk was reduced significantly if individuals maintained an ideal level of AHA's CVH guidelines of physical activity, fasting plasma glucose, total cholesterol, and smoking. However, our meta-analysis did not show a significant association between CVH score and global cognitive decline rate. Following AHA's CVH guidelines and maintaining CVH at an optimal level would substantially reduce the late-life dementia risk. More research is required to explore the link between a favorable CVH score and cognitive trajectories among cognitively asymptomatic older populations.

Keywords: Cardiovascular health; Dementia; Global cognitive function; Life’s Simple 7; Meta-analysis.

Publication types

Systematic Review
Meta-Analysis
Review
Research Support, Non-U.S. Gov't

MeSH terms

American Heart Association
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / prevention & control
Cognitive Dysfunction*
Dementia* / diagnosis
Dementia* / epidemiology
Dementia* / prevention & control
Health Status
Humans
Risk Factors