Long-term cardiovascular risk trajectory predicts cognitive decline, dementia

Cumulative cardiovascular risk is a significant factor in determining the risk for cognitive decline and dementia, according to a study published in Neurology.

“While vascular dementia de facto results from vascular injury, recent evidence has also implicated the role of cardiovascular factors in the progression of [Alzheimer’s disease],” Bryn Farnsworth von Cederwald, PhD, of the department of integrative medical biology at Umea University in Sweden, and colleagues wrote. “Notably, approximately 80% of patients diagnosed with AD exhibit vascular pathology when inspected at autopsy.”

Researchers sought to examine whether cardiovascular risk trajectory influences subsequent dementia and memory decline risk and hypothesized that cumulative, long-term cardiovascular risk — determined by the Framingham Risk Score (FRS) — would negatively affect cognitive outcomes.

They examined a sample of 1,244 initially healthy participants from the longitudinal, population based Betula study who were recruited at two separate time points (1988-1990 and 1993-1995). Researchers measured cardiovascular disease risk via the FRS, as well as performance of episodic memory and dementia status, at 5-year intervals across 20 to 25 years.

Results showed that cardiovascular risk increased moderately over time in 60% of the sample population, with observations of an accelerated increase in 18% of participants and minimal change in 22%. An accelerated cardiovascular risk trajectory predicted an increased risk of developing AD dementia [average RR, 3.3-5.7; 95% CI, 2.6-17.5 at the second time point (T2) and 1.9-6.7 at the fifth time point (T5)] or vascular dementia (aRR, 3.3-4.1; 95% CI, 1.1-16.6 at T2 and 1.5-7.6 at T5) and was associated with an increased risk for memory decline (aRR, 1.4-1.2; 95% CI, 1-1.9 at T2 and 1-1.5 at T5).

“Future research may benefit from further exploring how longitudinal [cardiovascular disease] risk affects the accumulation of neuropathology,” von Cederwald and colleagues wrote.