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Midlife Vascular Issues Increase Dementia Risk

Posted on April 12, 2017, 6 a.m. in Cardio-Vascular Alzheimer's Disease Blood Pressure Brain and Mental Performance

Having heart disease risks in midlife, such as diabetes, smoking, or high blood pressure leads to a greater risk for dementia later in life

A recent study indicates that the midlife factors for vascular risk are linked to a heightened risk for dementia later on in life. In particular, hypertension, smoking and diabetes in midlife are tied to a higher risk for dementia. In fact, midlife diabetes heightens the risk nearly as much as carrying the top risk factor for Alzheimer's, APOEe4 allele. The study's results were presented in a media briefing at the 2017 International Stroke Conference.

About the Research

The study's lead researcher, Rebecca F. Gottesman, aimed to gain a better understanding of whether the treatment of specific vascular risk factors makes a meaningful difference in terms of decreasing the odds of Alzheimer's. At the moment, other means of reducing the odds of Alzheimer's are insufficient. However, the medical community does understand how to treat and ward off vascular diseases. Gottesman, MD, PhD is an associate professor of epidemiology and neurology at the Johns Hopkins University in Maryland.

This biracial study included participants from four locales within the United States in the late 1980s. The participants were between the ages of 45 and 64. Vascular risk factors were analyzed at baseline. Patients were continually studied at intervals across a 25 year period. Nearly 16,000 participants were in the cohort. Over 1,500 cases of dementia were pinpointed at the assessment that took place between 2011 and 2013.

The Findings

It was expected that the risk for dementia would rise with age. Indeed, this expectation turned out to be the case. African American participants had the highest risk for dementia. Smoking, hypertension, not graduating from high school, diabetes and the presence of the APOE e4 allele were identified as the primary midlife risk factors for eventual dementia. Smoking turned out to be a risk factor for dementia solely in Caucasians. The APOE allele produced a stronger effect in Caucasians than African Americans.

Why the Study is so Important

The study is valuable as it pinpoints factors that can be identified and subsequently modified at the midlife point of an individual's life that play a role in cognitive dysfunction as the aging process occurs. It is clear that the health of one's vascular system in the middle years of his life is vitally important to brain health across the aging process. It is hoped that the study's findings will spur people to alter their habits and obtain treatment for medical conditions to guard against dementia.

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The study was funded by the National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke. Dr Gottesman is associate editor of the journal Neurology. International Stroke Conference (ISC) 2017. Abstract 98. Presented February 22, 2017.

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