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Age at Onset of Heart Failure and Subsequent Risk of Dementia: A Longitudinal Cohort Study
Fanfan Zheng1, Jie Liang1, Chenglong Li2
1Department of Clinical Nursing, School of Nursing, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Insights
Younger age at heart failure (HF) onset is linked to a higher dementia risk. Individuals experiencing HF before 65 years old face a particularly elevated risk and require close monitoring.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Geriatrics
Background:
- Heart failure (HF) onset age is decreasing.
- The link between early HF onset and dementia risk is unclear.
Purpose of the Study:
- To investigate if younger age at HF onset increases dementia risk.
- To analyze the association between HF onset age and subsequent dementia, including Alzheimer's disease (AD) and vascular dementia (VD).
Main Methods:
- Utilized UK Biobank cohort data.
- Employed Cox regression and propensity score matching to assess HF and onset age impact on dementia.
- Analyzed associations with all-cause dementia, AD, and VD.
Main Results:
- HF presence increased all-cause dementia risk (HR: 1.14).
- Each 10-year decrease in HF onset age correlated with higher dementia risk (all-cause: HR 1.18, AD: HR 1.64, VD: HR 1.27).
- Risk escalated significantly with earlier onset: HF before 65 years showed the highest association with all-cause dementia (HR: 1.67), AD, and VD.
Conclusions:
- Younger age at HF onset is associated with increased dementia risk.
- Individuals with HF onset before 65 are a vulnerable group for dementia.
- Early intervention and monitoring are crucial for this population to mitigate dementia risk.
Background:
The average age at onset of heart failure (HF) shows a progressive decrease in recent years; however, the association between age at onset of HF and risk of subsequent dementia remains undetermined.
Objectives:
This study sought to examine whether younger onset age of HF is associated with a higher risk of incident dementia.
Methods:
Individual-level data from the UK Biobank cohort study were analyzed in the present study. Cox regression models and the propensity score matching method were used to analyze the associations of HF and its onset age with subsequent all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD).
Results:
Compared with 442,791 participants without HF, those with HF had a higher risk of all-cause dementia (HR: 1.14). Among 14,413 participants with HF, multivariable-adjusted HRs for all-cause dementia, AD, and VD were 1.18, 1.64, and 1.27, respectively, per 10-year decrease in age at HF onset. The propensity score matching analyses found that the strength of association between HF and all-cause dementia increased with decreasing onset age of HF (≥75 years, HR: 1.05; 65-74 years, HR: 1.10; <65 years, HR: 1.67) after multivariable adjustment. Similarly, participants with onset age of HF <65 years had the greatest HRs for incident AD and VD, compared with their matched control subjects.
Conclusions:
Younger age at HF onset was associated with increased risk of dementia. Individuals with an onset age of HF before 65 years of age may represent a particularly vulnerable population for dementia irrespective of subtypes and need careful monitoring and timely intervention to attenuate subsequent risk of incident dementia.
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