Impact of risk factor burden and vascular bed involvement on dementia risk in individuals with established cardiovascular disease
J De Leijer, G J Biessels, F L J Visseren, T A C M Vissers, R W M Vernooij, F J Wolters, S Sedaghat, P L Lutsey, M J L Peters, A Singh Manoux, T T Van SlotenAbstract
Aim
To determine how cardiovascular disease (CVD) risk factor burden and the number of affected vascular beds relate to the risk of dementia in individuals with established CVD.
Methods
Participants were from the prospective, single-center UCC-SMART cohort study, recruited between 1996-2024. CVD risk factor burden was defined as the number of traditional CVD risk factors present. The number of affected vascular beds was the count of coronary artery disease, cerebrovascular disease, and peripheral artery disease. Relations with all-cause dementia were estimated with Cox regression adjusted for confounding factors.
Results
10,321 participants (mean age 61±10 years; 27% female) were included, of whom 6,480 (63%) had coronary artery disease, 3,378 (33%) had cerebrovascular disease, and 2,681 (26%) had peripheral artery disease. During a median follow-up of 10.1 years (IQR: 5.0-15.7), 296 (2.9%) dementia cases were identified. Dementia risk increased with higher CVD risk factor burden; hazard ratios compared to participants with 0-1 risk factors were 1.35 (95% CI: 0.95-1.92) for participants with 2 risk factors, 1.58 (95% CI: 1.10-2.26) for participants with 3 risk factors, and 1.87 (95% CI: 1.31-2.67) for participants with 4-9 risk factors. Compared to participants with 1 affected vascular bed, participants with 2 or 3 affected vascular beds had a higher dementia risk, with hazard ratios of 1.32 (95% CI: 1.02-1.71) and 1.90 (95% CI: 1.05-3.43), respectively.
Conclusion
Higher CVD risk factor burden and higher number of affected vascular beds are related to increased dementia risk in individuals with established CVD. These findings underscore the importance of stringent cardiovascular risk management as a potential strategy to lower dementia risk in this population.afbeelding1.jpgafbeelding2.jpg