Extracerebral microvascular burden links to dementia risk and brain structural changes: Evidence from a large‐scale cohort study
Jialin Li, Yingzhe Wang, Chunyu Yin, Mei Cui, Jincheng Li, Chen Suo, Kelin Xu, Zhenqiu Liu, Li Jin, Xingdong Chen, Yanfeng JiangAbstract
INTRODUCTION
The contribution of extracerebral microvascular disease (MVD) burden to dementia risk remains unclear.
METHODS
Among 484,896 UK Biobank participants (median follow‐up 8.5 years), baseline extracerebral MVD (retinopathy, nephropathy, peripheral neuropathy) and incident dementia were identified via hospital records. Aging‐related brain changes were evaluated using magnetic resonance imaging (MRI) ‐derived volumes and white matter integrity.
RESULTS
MVD was 2.6 times more prevalent among participants who developed dementia than dementia‐free individuals (8.0% vs 3.1%) and ranked second among vascular comorbidities after coronary artery disease. Each additional MVD burden was associated with a higher dementia risk, comparable to coronary artery disease (hazard ratio = 1.69 vs. 1.72). Earlier onset conferred stronger risk, and coexisting vascular diseases further amplified associations ( p ‐trend < 0.001). MVD burden was also associated with global brain atrophy and reduced white matter integrity.
DISCUSSION
Extracerebral MVD burden is associated with dementia risks and brain imaging changes, supporting integrated vascular risk stratification and management for dementia.