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Cardiovascular risk burden, dementia risk and brain structural imaging markers: a study from UK Biobank
Yaying Cao1,2, Gaohong Zhu3, Chengwu Feng2
1Department of Food Nutrition and Health, School of Medicine and Health, Harbin Institute of Technology, Harbin, Heilongjiang, China.
Insights
High cardiovascular risk burden increases dementia risk, including Alzheimer's and vascular dementia, largely independent of genetics. This highlights the importance of managing heart health for brain health.
Area of Science:
- Neuroscience
- Cardiology
- Gerontology
Background:
- Cardiovascular risk burden is linked to dementia risk and brain structure changes.
- The independent roles of genetics and incident cardiovascular disease (CVD) in this association require further investigation.
Purpose of the Study:
- To assess the association between overall cardiovascular risk burden and the risk of major dementia subtypes.
- To explore the influence of genetics and incident CVD on this relationship.
- To examine the impact of cardiovascular risk on brain structure volumes.
Main Methods:
- A prospective UK Biobank study of 354,654 participants (mean age 56.4) free of CVD and dementia.
- Cardiovascular risk assessed using the Framingham General Cardiovascular Risk Score (FGCRS).
- Brain MRI data analyzed for 15,104 participants; dementia cases identified via inpatient and death registers.
Main Results:
- Higher FGCRS correlated with increased all-cause, Alzheimer's, and vascular dementia risk, independent of lifestyle, clinical factors, and polygenic risk score (PRS).
- Incident stroke and coronary heart disease explained 14% of the FGCRS-dementia association.
- Higher FGCRS linked to increased white matter hyperintensities and reduced grey/cortical volumes.
Conclusions:
- Cardiovascular risk burden is associated with major dementia subtypes, independent of CVD onset and genetic predisposition.
- Managing cardiovascular risk factors is crucial for mitigating dementia risk.
- Findings emphasize the link between cardiovascular health and brain structure integrity.
Background:
Cardiovascular risk burden is associated with dementia risk and neurodegeneration-related brain structure, while the role of genetics and incident cardiovascular disease (CVD) remains unclear.
Aims:
To examine the association of overall cardiovascular risk burden with the risk of major dementia subtypes and volumes of related brain regions in a large sample, and to explore the role of genetics and CVD onset.
Methods:
A prospective study among 354 654 participants free of CVD and dementia (2006-2010, mean age 56.4 years) was conducted within the UK Biobank, with brain magnetic resonance imaging (MRI) measurement available for 15 104 participants since 2014. CVD risk burden was evaluated by the Framingham General Cardiovascular Risk Score (FGCRS). Dementia diagnosis was ascertained from inpatient and death register data.
Results:
Over a median 12.0-year follow-up, 3998 all-cause dementia cases were identified. Higher FGCRS was associated with increased all-cause dementia risk after adjusting for demographic, major lifestyle, clinical factors and the polygenic risk score (PRS) of Alzheimer's disease. Comparing the high versus low tertile of FGCRS, the odds ratios (ORs) and 95% confidence intervals (CIs) were 1.26 (1.12 to 1.41) for all-cause dementia, 1.67 (1.33 to 2.09) for Alzheimer's disease and 1.53 (1.07 to 2.16) for vascular dementia (all ptrend<0.05). Incident stroke and coronary heart disease accounted for 14% (95% CI: 9% to 21%) of the association between FGCRS and all-cause dementia. Interactions were not detected for FGCRS and PRS on the risk of any dementia subtype. We observed an 83% (95% CI: 47% to 128%) higher all-cause dementia risk comparing the high-high versus low-low FGCRS-PRS category. For brain volumes, higher FGCRS was associated with greater log-transformed white matter hyperintensities, smaller cortical volume and smaller grey matter volume.
Conclusions:
Our findings suggest that the positive association of cardiovascular risk burden with dementia risk also applies to major dementia subtypes. The association of cardiovascular risk burden with all-cause dementia is largely independent of CVD onset and genetic predisposition to dementia.
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