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Cardiovascular Health at Midlife and Alzheimer Disease Biomarkers

Christina S Dintica1, Xiaqing Jiang1, Leslie M Shaw2

  • 1Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA.

Medrxiv : the Preprint Server for Health Sciences
|May 1, 2026
PubMed

Insights

Poor cardiovascular health in midlife is linked to early Alzheimer's disease (AD) biomarkers. This includes amyloid burden and brain changes, highlighting the importance of heart health for cognitive function.

Area of Science:

  • Neuroscience
  • Cardiovascular Health
  • Aging Research

Background:

  • Cardiovascular health is linked to cognitive decline and Alzheimer's disease (AD) risk, primarily studied in older adults.
  • Research has focused less on midlife vascular and lifestyle factors' impact on early AD biomarkers.

Purpose of the Study:

  • To investigate the association between midlife cardiovascular health and early AD plasma and imaging biomarkers.
  • To determine if vascular and lifestyle factors in early midlife predict AD pathology in late midlife.

Main Methods:

  • Utilized data from 1,406 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study.
  • Assessed cardiovascular health using the American Heart Association's "life's essential 8" (LE8) guidelines in early midlife.
  • Measured AD biomarkers including plasma phosphorylated tau 217 (ptau-217), amyloid beta 42/40 ratio (Aβ42/40), and brain atrophy patterns (SPARE-AD) in late midlife using linear regression.

Main Results:

  • Poor and intermediate cardiovascular health (LE8 scores) were associated with a lower Aβ42/40 ratio compared to ideal LE8.
  • No significant association was found between LE8 group and ptau-217 levels.
  • Poor cardiovascular health was linked to a higher SPARE-AD atrophy pattern, indicating greater AD-like brain changes.

Conclusions:

  • Suboptimal cardiovascular health in midlife, assessed by AHA LE8, is associated with less favorable early Alzheimer's disease biomarker profiles.
  • Findings suggest that poor cardiovascular health may contribute to increased amyloid burden and structural brain changes indicative of AD.
  • Midlife cardiovascular health is a critical factor influencing AD pathology development.
Abstract

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