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Cardiovascular Health and Brain Heath: Lifelong Connection

     

Two studies published in August in JAMA highlight and clarify the connection between heart health and brain health, especially the risk of dementia.

While the overall number of people developing dementia continues rise along with the aging population, the rate of new cases of dementia is beginning to fall. One possible factor contributing to the decline is improved control of cardiovascular risk factors. Previous studies have linked cardiovascular risks factors in mid-life with development of cognitive impairment and dementia later in life.

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The new studies look at cardiovascular health among young adults and among older adults. Both studies draw on the American Heart Association’s Life’s Simple 7 metric being used to promote and measure cardiovascular health. The metric incudes seven modifiable risk factors: four modifiable behaviors (nonsmoking, healthy diet, physical activity and body mass index) and three modifiable biological health factors (low blood pressure, low cholesterol and low fasting glucose).

In the study looking at older adults, Cecillia Samieri, Ph.D., and colleagues followed more than 6,600 older adults with an average age of 74 for more than eight years. They found strong associations between cardiovascular health and dementia. Among the older adults, having a greater number of optimal cardiovascular health metrics and a higher cardiovascular health score were associated with lower cognitive decline and lower risk of dementia. People with poorer cardiovascular health were significantly more likely to develop dementia during the study period. Samieri and colleagues suggest that their findings may support promotion of cardiovascular health to help prevent cognitive decline and dementia.

A study by Wilby Williams, M.Sc., M.R.C.P., and colleagues looked at cardiovascular health of younger adults. The study involved 125 young adults, with an average age of 25, without know cardiovascular disease. They were assessed for the seven measures of optimal cardiovascular health and magnetic resonance imaging (MRI) was used to assess cerebral structure and vascular function.

The study found that having a higher number of optimal cardiovascular measures was associated with several measures of brain health, such as more blood flow in the brain and fewer white matter hyperintense lesions. In an accompanying editorial in JAMA, Jeffrey Saver, M.D. and Mary Cushman, M.D., note that “it is likely that these changes are the pre-clinical precursors of more severe late-life neurovascular compromise.” The findings emphasize the importance of preventing and addressing cardiovascular risk factors even among young adults, they note.

It’s important to note that both studies were observational and show association, not causation. However, they do add to the evidence supporting promotion of cardiovascular health in adults of all ages to help lower the risk of dementia and cognitive decline. They provide more support for adopting a healthy lifestyle.

References

  • Williamson, W, et al. Association of Cardiovascular Risk Factors with MRI Indices of Cerebrovascular Structure and Function and White Matter Hyperintensities in Young Adults. JAMA, 2018;320(7)
  • Samieri, C., et al. Association of Cardiovascular Health Level in Older Age with Cognitive Decline and Incident Dementia. JAMA. 2018:320(7);657-664.
  • Saver, JL and Cushman, M. Striving for Ideal Cardiovascular and Brain Health: It is never too early or too late. JAMA. 2018;320(7):645-46.

     

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