Dementia Risk Increased by Diabetes, Cardiovascular Risk Factors

Middle-aged Americans who are smokers and those who have diabetes and/or high blood pressure are more likely to suffer from dementia, according to a long-term study from Johns Hopkins University.

Additionally, the study found a link between dementia and prehypertension, which was previously unknown. Walter J. Koroshetz, MD, director of the NIH’s National Institute of Neurological Disorders and Stroke (NINDS) said that the study’s findings support the “importance of controlling vascular risk factors like high blood pressure early in life.”

The study, led by Rebecca Gottesman, MD, PhD, and professor of neurology at Johns Hopkins University, examined data from 15,744 participants in the Atherosclerosis Risk in Communities (ARIC) study. In an average follow-up of 23 years, 1,516 developed dementia.

“Our results contribute to a growing body of evidence linking midlife vascular health to dementia,” Gottesman said in a statement. “These are modifiable risk factors. Our hope is that by addressing these types of factors early, people can reduce the chances that they will suffer from dementia later in life.”

Research showed that age and the presence of APOE4, an Alzheimer’s associated gene, were the most notable increasers of risk. The study showed that the presence of hypertension or diabetes were almost as accurate a predictor for developing dementia as the presence of APOE4.

The study also showed that whites with one copy of APOE4 had a higher chance of dementia than blacks, but blacks had a higher overall risk. Smoking increased the chances of dementia for whites, but not blacks. Overall, race did not have any influence on the link found between dementia and the vascular risk factors that were identified in the study.

Attempts to reconcile the findings with the presence of stroke history in participants were also made, as vascular risk factors are also associated with strokes, but the team found that diabetes, hypertension, prehypertension, and smoking increased dementia risk for both those who had a stroke and the stroke-free participants.

Gottesman’s team also analyzed data from a separate study from the NIH’s National Institute on Aging, revealing that, in patients that did not have dementia, the presence of 1 or more vascular risks was associated with higher beta amyloid levels. Beta amyloid often accumulates in patients with Alzheimer’s.

The study was originally published in JAMA Neurology.

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