Key result
Cardiometabolic multimorbidity linked to ~3-fold higher dementia risk, peaking in Black and Hispanic groups.
Why the study?
Racial/ethnic minoritized groups in the US have a higher prevalence of cardiometabolic multimorbidity and higher dementia risk, prompting evaluation of the relationship between cardiometabolic multimorbidity and dementia onset across racial/ethnic groups.
Does cardiometabolic multimorbidity increase the risk of dementia onset in middle-aged and older adults, and does this risk vary by race/ethnicity?
Does cardiometabolic multimorbidity increase the risk of dementia onset in middle-aged and older adults, and does this risk vary by race/ethnicity?
Cardiometabolic multimorbidity significantly increases the risk of dementia onset, with disproportionately higher risks observed in Black and Hispanic middle-aged and older adults.
Should not yet change practice; extends observational links to racial disparities but leaves causal effects open.
Background Racial/ethnic minoritized groups in the United States have a higher prevalence of cardiometabolic multimorbidity and experience a higher risk of dementia. This study evaluates the relationship between cardiometabolic multimorbidity and dementia onset according to racial/ethnic group in a nationally representative cohort of U.S. middle-aged and older adults. Methods Data from the Health & Retirement Study (1998–2018, N = 7,960, mean baseline age 59.4 years) and discrete-time survival models were used to estimate differences in the risk of dementia onset, defined by Langa–Weir classification. Models included race/ethnicity (non-Hispanic White, non-Hispanic Black, and Hispanic), chronic disease/multimorbidity categories (no disease, one disease, cardiovascular multimorbidity, metabolic multimorbidity, cardiometabolic multimorbidity, other multimorbidity), age, sex, education, wealth, body-mass index, and proxy status. Results Over a mean follow-up of 14.6 years, 7.7% of the participants (n = 614) developed dementia. In the fully adjusted model, participants with cardiometabolic multimorbidity had the highest risk of dementia onset (HR:3.27, 95%CI: 2.06, 5.21), followed by metabolic (HR:1.83, 95%CI: 1.14, 2.94), and cardiovascular (HR:1.81, 95%CI: 1.24, 2.64) multimorbidity, relative to participants with no disease. The risk of dementia was significantly greater among Black (HR: 6.40, 95% CI: 3.84, 10.67) and Hispanic participants (HR: 4.90, 95% CI: 2.85, 8.43) with cardiometabolic multimorbidity, compared with White adults with no disease. Conclusions Individuals from racial/ethnic minoritized groups have a higher risk of dementia. The risk of dementia onset was significantly greater for Black and Hispanic participants experiencing cardiometabolic multimorbidity, highlighting the value of intervening in cardiometabolic conditions among middle-aged and older adults, in particular, those from racial/ethnic minoritized backgrounds to reduce the risk of developing dementia.
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Chen et al. (2025) studied this question. Participants with cardiometabolic multimorbidity had a 3.27-fold increased risk of dementia onset, with Black (HR: 6.40) and Hispanic (HR: 4.90) groups at highest risk.
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