Dementia is a progressive disease caused by multiple factors that begin developing over a lengthy preclinical period—that could be 15 to 20 years long—before dementia symptoms appear. Unfortunately, most studies only assess dementia risk factors later in life and don’t examine the harbingers of cognitive decline during the decades leading up to potentially debilitating dementia.
The latest study led by Séverine Sabia is noteworthy because it examines the association between cardiovascular health and dementia risk in 7,899 British men and women during midlife and over the next 25 years. Sabia is a research associate from the Department of Epidemiology and Public Health at University College London (UCL) and the Université de Paris.
For this study, Sabia, along with senior author Archana Singh-Manoux and colleagues, examined cardiovascular health scores during midlife based on The American Heart Association’s Life’s Simple 7 guidelines in relation to cognitive decline and dementia later in life.
The AHA describes Life’s Simple 7 as “the seven risk factors people can improve through lifestyle changes that help achieve ideal cardiovascular health.” Although these guidelines were initially designed for the prevention of cardiovascular disease (CVD), they are increasingly being viewed as having dementia-preventing potential.
Life’s Simple 7 is broken down into four behavioral metrics (physical activity, diet, smoking, body mass index) and three biological metrics (blood pressure, blood cholesterol, fasting glucose). Rating scores are categorized as “poor” (scores 0-6), “intermediate” (7-11), and “optimal” (12-14) cardiovascular health.
Of note, each incremental movement towards “optimal” on the 14-point cardiovascular health scale during midlife was associated with a similar reduction in the risk of dementia later in life. Higher cardiovascular health scores at age 50 were also correlated with higher gray matter brain volumes two decades later.
“Reductions in risk of dementia were evident across the continuum of the cardiovascular health score, suggesting that even small improvements in cardiovascular risk factors are likely to be beneficial for cognitive health,” Sabia and coauthors write. “Our results showing cardiovascular health assessed at age 50 to be associated with dementia and brain volume 20 years later are in agreement with previous studies based on shorter follow-up. These results highlight the importance of the cardiovascular health score in promoting brain health at older ages.”
After taking potentially influential factors into account, the researchers conclude that adherence to Life’s Simple 7 cardiovascular health recommendations in midlife is associated with a lower risk of dementia later in life.