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Published on: September 26, 2018

Long-Term Association of Cardiovascular Risk Burden With Dementia Risk: The Role of Life-Course Confounders in an

Roya Riahi1, Mohammad Ali Mansournia2, Negin Badihian3

  • 1Department of Epidemiology and Biostatistics, School of Public Health Isfahan University of Medical Sciences Isfahan Iran.

Journal of the American Heart Association
|May 25, 2026
PubMed

Insights

Managing cardiovascular risk factors (CVRFs) over time is crucial for dementia prevention. Reducing CVRF burden is associated with a lower dementia risk, highlighting the importance of early and sustained interventions.

Area of Science:

  • Neuroscience
  • Public Health
  • Epidemiology

Background:

  • Dementia prevention is a global health priority.
  • Individual cardiovascular risk factors (CVRFs) are linked to dementia, but cumulative burden and life-course factors require further understanding.
  • This study investigates the longitudinal association between changes in CVRF burden and dementia risk.

Purpose of the Study:

  • To estimate the longitudinal association between changes in cardiovascular risk factor burden and dementia risk.
  • To evaluate dementia risk under hypothetical scenarios of varying CVRF burden over time.
  • To identify the role of life-course confounders in dementia risk.

Main Methods:

  • Analysis of 6051 participants from the Atherosclerosis Risk in Communities (ARIC) study with a median follow-up of 21.9 years.
  • Utilized the doubly robust g-formula method to estimate 20-year dementia risk differences.
  • Accounted for competing mortality and time-varying confounding.

Main Results:

  • At baseline, 23.1% of participants had ≥3 CVRFs; 17% developed dementia during follow-up.
  • Low birth weight, midlife depression, and poor oral health were identified as significant confounders.
  • Maintaining low CVRF burden reduced dementia risk (risk difference: -4.31%), while high burden increased it (risk difference: 10.5%).

Conclusions:

  • Higher cumulative cardiovascular risk factor burden over time is significantly associated with increased dementia risk.
  • Findings underscore the importance of early and sustained management of CVRFs for dementia prevention.
  • Integrating early-life and psychological factors into prevention strategies is recommended.
Abstract

Keywords:
Bayesian causal methodcardiovascular risk factorsdementialongitudinal data

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