RT Journal Article
SR Electronic
T1 Longitudinal associations of cardiovascular health and vascular events with incident dementia
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP svn-2023-002665
DO 10.1136/svn-2023-002665
A1 Ou, Ya-Nan
A1 Kuo, Kevin
A1 Yang, Liu
A1 Zhang, Ya-Ru
A1 Huang, Shu-Yi
A1 Chen, Shi-Dong
A1 Deng, Yue-Ting
A1 Guo, Yu
A1 Zhang, Rui-Qi
A1 Wu, Bang-Sheng
A1 Tan, Lan
A1 Dong, Qiang
A1 Feng, Jian-Feng
A1 Cheng, Wei
A1 Yu, Jin-Tai
YR 2023
UL http://svn.bmj.com/content/early/2023/10/20/svn-2023-002665.abstract
AB Introduction Evidence supporting cardiovascular diseases could increase the risk of dementia remains fragmented. A comprehensive study to illuminate the distinctive associations across different dementia types is still lacking. This study is sought to: (1) determine the clinical validity of Framingham General Cardiovascular Risk Score (FGCRS) for dementia assessment and (2) examine the associations between cardiovascular diseases and the risk of dementia.Methods A total of 432 079 dementia-free individuals at baseline from UK Biobank were included. Multivariable Cox proportional hazard models were used to investigate the prospective associations for FGCRS and a series of cardiovascular diseases with all-cause dementia (ACD) and its major components, Alzheimer’s disease (AD) and vascular dementia (VaD).Results During a median follow-up of 110.1 months, 4711 individuals were diagnosed with dementia. FGCRS was associated with increased risks across the dementia spectrum. In stratification analysis, high-risk groups have demonstrated the greatest dementia burdens, particularly to VaD. Over 74 traits, 9 adverse associations, such as chronic ischaemic heart disease (ACD: HR=1.354; AD: HR=1.269; VaD: HR=1.768), atrioventricular block (ACD: HR=1.562; AD: HR=1.556; VaD: HR=2.069), heart failure (ACD: HR=1.639; AD: HR=1.543; VaD: HR=2.141) and hypotension (ACD: HR=2.912; AD: HR=2.361; VaD: HR=3.315) were observed. Several distinctions were also found, with atrial fibrillation, cerebral infarction, and haemorrhage only associated with greater risks of ACD and VaD.Discussion By identifying distinctive associations between cardiovascular diseases and dementia, this study has established a comprehensive ‘mapping’ that may untangle the long-standing discrepancy. FGCRS has demonstrated its predictivity beyond cardiovascular diseases burdens, suggesting potential opportunities for implantation.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. According to European law (General Data Protection Regulation), data containing potentially identifying or sensitive patients’ information are restricted. However, for academic researchers, data could be available on request via the UK Biobank.