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August 3, 2023Alzheimer s & DementiaOpen Access

Cardiovascular health and cognitive outcomes: Findings from a biracial population‐based study in the United States

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Key result

Higher CVH scores linked to ~16% lower risk of incident Alzheimer's dementia per point.

  • HR 0.84
  • 95% CI 0.76, 0.94
  • n=1,702

Why the study?

The study was conducted to evaluate the association of cardiovascular health with cognitive outcomes, including incident Alzheimer's dementia, cognitive decline, and brain injury and structure.

Does a higher cardiovascular health score reduce the risk of incident Alzheimer's dementia and cognitive decline in older adults?

Population

1702 Black or African American and White participants in Chicago, Illinois

Comparison

Cardiovascular health based on seven risk factors

Design

Population-based cohort study

Authors

ADAnisa DhanaCDCharles DeCarliKDKlodian Dhana

Discussion

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Member takes

Overview

Supports CVH optimization to lower AD risk in older adults; leaves open whether interventions reduce incidence in trials.

Study Design

Type

Cohort (n=1,702)

Structured PICO

Does a higher cardiovascular health score reduce the risk of incident Alzheimer's dementia and cognitive decline in older adults?

P
Population
1,702 Black and White older adults aged 65 and older from a population-based cohort in Chicago, free of dementia at baseline, followed for up to 18 years to assess incident Alzheimer's dementia.
E
Exposure
Higher Cardiovascular Health (CVH) score based on the American Heart Association's Life's Simple 7 metrics (score ranging from 7-14 points).
C
Comparator
Lower Cardiovascular Health (CVH) score (0-6 points).
O
Outcome
Incident Alzheimer's dementia.hard clinical

Main Result

Hazard Ratio: 0.84 (95% CI 0.76–0.94)

Higher cardiovascular health scores based on Life's Simple 7 are associated with a significantly lower risk of incident Alzheimer's dementia and slower cognitive decline in older adults.

Limitations

  • Components of CVH including dietary intake, physical activity, and smoking history were based on self-report, which is prone to misclassification.
  • CVH was determined at baseline without investigating changes during follow-up.
  • Findings are based on African American and white older adults in Chicago, limiting generalizability to younger populations and other ethnicities.
  • Components of CVH (dietary intake, physical activity, smoking history, and partly diabetes) were based on self-report, which is prone to misclassification.
  • Findings are based on African American and white older adults living in the southside of Chicago, limiting generalizability to younger populations and other ethnicities.

Cite This Study

Dhana et al. (2023) conducted a cohort in Alzheimer's dementia (n=1,702). Cardiovascular health (CVH) score vs. Lower cardiovascular health score was evaluated on Incident Alzheimer's dementia (HR 0.84, 95% CI 0.76, 0.94). Higher cardiovascular health scores were associated with a lower risk of incident Alzheimer's dementia, with a hazard ratio of 0.84 per one additional point in the CVH score.

synapsesocial.com/papers/6a1ff6cd3224f8dacd0db1a0https://doi.org/10.1002/alz.13421
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study2019 · 214 citations
  2. 2Mixed brain pathologies account for most dementia cases in community-dwelling older persons2007 · 2,040 citations
  3. 3Changes in Risk Factors and the Decline in Mortality from Cardiovascular Disease1990 · 493 citations
  4. 4Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction2010 · 4,837 citations
  5. 5Association of Life's Simple 7 with incident dementia and its modification by the apolipoprotein E genotype2021 · 56 citations