Longitudinal associations of cardiovascular health and vascular events with incident dementia

Ya-Nan Ou; Kevin Kuo; Liu Yang; Ya-Ru Zhang; Shu-Yi Huang; Shi-Dong Chen; Yue-Ting Deng; Yu Guo; Rui-Qi Zhang; Bang-Sheng Wu; Lan Tan; Qiang Dong; Jian-Feng Feng; Wei Cheng; Jin-Tai Yu

doi:10.1136/svn-2023-002665

Longitudinal associations of cardiovascular health and vascular events with incident dementia

Stroke Vasc Neurol. 2023 Oct 12:svn-2023-002665. doi: 10.1136/svn-2023-002665. Online ahead of print.

Authors

Ya-Nan Ou¹, Kevin Kuo², Liu Yang², Ya-Ru Zhang², Shu-Yi Huang², Shi-Dong Chen², Yue-Ting Deng², Yu Guo², Rui-Qi Zhang², Bang-Sheng Wu², Lan Tan¹, Qiang Dong², Jian-Feng Feng^{3

4}, Wei Cheng^{2

3

4}, Jin-Tai Yu⁵

Affiliations

¹ Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, People's Republic of China.
² Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
³ Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, People's Republic of China.
⁴ Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, People's Republic of China.
⁵ Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China jintai_yu@fudan.edu.cn.

PMID: 37827852
DOI: 10.1136/svn-2023-002665

Abstract

Introduction: Evidence supporting cardiovascular diseases could increase the risk of dementia remains fragmented. A comprehensive study to illuminate the distinctive associations across different dementia types is still lacking. This study is sought to: (1) determine the clinical validity of Framingham General Cardiovascular Risk Score (FGCRS) for dementia assessment and (2) examine the associations between cardiovascular diseases and the risk of dementia.

Methods: A total of 432 079 dementia-free individuals at baseline from UK Biobank were included. Multivariable Cox proportional hazard models were used to investigate the prospective associations for FGCRS and a series of cardiovascular diseases with all-cause dementia (ACD) and its major components, Alzheimer's disease (AD) and vascular dementia (VaD).

Results: During a median follow-up of 110.1 months, 4711 individuals were diagnosed with dementia. FGCRS was associated with increased risks across the dementia spectrum. In stratification analysis, high-risk groups have demonstrated the greatest dementia burdens, particularly to VaD. Over 74 traits, 9 adverse associations, such as chronic ischaemic heart disease (ACD: HR=1.354; AD: HR=1.269; VaD: HR=1.768), atrioventricular block (ACD: HR=1.562; AD: HR=1.556; VaD: HR=2.069), heart failure (ACD: HR=1.639; AD: HR=1.543; VaD: HR=2.141) and hypotension (ACD: HR=2.912; AD: HR=2.361; VaD: HR=3.315) were observed. Several distinctions were also found, with atrial fibrillation, cerebral infarction, and haemorrhage only associated with greater risks of ACD and VaD.

Discussion: By identifying distinctive associations between cardiovascular diseases and dementia, this study has established a comprehensive 'mapping' that may untangle the long-standing discrepancy. FGCRS has demonstrated its predictivity beyond cardiovascular diseases burdens, suggesting potential opportunities for implantation.

Keywords: Atrial Fibrillation; Blood Pressure; Brain; Cognitive Dysfunction; Risk Factors.