Early-onset heart disease drives risk for Alzheimer's disease, other dementias
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Key takeaways:
- Adults diagnosed with coronary heart disease before age 45 years are more likely to develop dementia.
- Researchers observed increased risks for Alzheimer’s disease, vascular dementia and other dementias.
Adults with a diagnosis of coronary heart disease before age 45 years are 36% more likely to develop dementia over 13 years of follow-up compared with those without a CHD diagnosis, data from the UK Biobank show.
In an analysis of more than 430,000 adults, researchers also found that risk for dementia rose in direct proportion to the younger age of CHD onset, Fanfan Zheng, PhD, of the School of Nursing at Peking Union Medical College in Beijing, and colleagues wrote in the Journal of the American Heart Association.
Data were derived from Liang J, et al. J Am Heart Assoc. 2023;doi:10.1161/JAHA.123.031407.
“What surprised us most was the linear relationship between the age of coronary heart disease onset and dementia,” Zheng said in a press release. “This shows the huge detrimental influence of premature coronary heart disease on brain health.”
Zheng and colleagues analyzed data from 432,667 adults participating in the UK Biobank, an ongoing, population-based cohort (mean age, 57 years; 54.6% women). Researchers collected on the diagnosis of CHD and dementia at baseline (2006-2010) and at follow-up visits across 13 years and used propensity score matching to evaluate the association between different ages at CHD onset and incident dementia.
Within the cohort, 11.7% had CHD, of whom 21.2% underwent revascularization or CABG. During a median follow-up of 12.8 years, researchers observed 5,876 cases of all-cause dementia, including 2,540 cases of Alzheimer’s disease and 1,220 cases of vascular dementia.
Compared with participants without CHD, those with CHD had higher risk for developing all-cause dementia, Alzheimer’s disease and vascular dementia. Researchers found that younger age at CHD onset (per 10-year decrease) was associated with elevated risks for all-cause dementia (HR = 1.25; 95% CI, 1.2-1.3; P < .001), Alzheimer’s disease (HR = 1.29; 95% CI, 1.2-1.38; P < .001) and vascular dementia (HR = 1.22; 95% CI, 1.13-1.31; P < .001).
After propensity-score matching, patients with CHD had higher risks for all-cause dementia, Alzheimer’s disease and vascular dementia than matched controls among all onset age groups, with the HRs gradually elevated with decreasing age at CHD onset.
In subgroup analyses, researchers found that statin use, current drinking and diabetes modified the association between CHD and incident dementia.
“As more people live longer and are diagnosed with coronary heart disease at a younger age, it is likely there will be a large increase in the number of people living with dementia in years to come,” Zheng said in the release. “Health care professionals should be aware of individuals diagnosed with coronary heart disease at a young age. The next step is to determine whether modifying cardiovascular risk early in life will promote better brain health later in life.”
Reference:
- Coronary heart disease before age 45 may increase risk of dementia later in life. https://newsroom.heart.org/news/coronary-heart-disease-before-age-45-may-increase-risk-of-dementia-later-in-life. Published on Nov. 29, 2023. Accessed on Nov. 29, 2023.
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