Risk factors associated with the development of dementia vary with age and have been shown by longitudinal analysis.
Diabetes at age 55 (HR 3.35, P= 0.003) and high systolic blood pressure (HR 1.17, P= 0.006) is the most important predictor of future dementia, Emer McGrath, MBBCh, PhD, and PhD at the National University of Ireland, Galway. Neurology..
At age 65, non-stroke cardiovascular disease (HR 2.12, P= 0.001) was the most important risk factor for predicting dementia for 10 years. For people in their 70s, diabetes (HR 1.97, P<0.001) and stroke (HR 2.43, P= 0.006) You are at the top of the list.
Diabetes at age 80 (HR 1.45, P= 0.02), History of stroke (HR 1.57, P= 0.03), and the use of antihypertensive drugs (HR 0.68, P<0.001) The most strongly predicted 10-year dementia.
“Predicting future risks of dementia is likely to need to be done at the individual level, taking into account age, gender, vascular risk burden, and end organ damage,” McGrath said. rice field. Today’s Med Page.
“Controlling high blood pressure, preventing diabetes, and following a healthy lifestyle may reduce the risk of dementia later,” she added.
Middle-aged factors including obesityLack of exercise, low education, and Multi-morbidity Previous studies have been associated with subsequent dementia. In this analysis, McGrath et al. Evaluated the relationship between all-cause dementia and vascular risk factors in the Framingham Heart Study. Genetic risk Alzheimer’s disease score for their model.
McGrath et al. Stated that FSRP was developed and validated to predict a 10-year stroke risk for people over the age of 55. “FSRP is also associated with brain atrophy and cognitive decline in community-based settings,” they write. “But it is unclear whether FSRP predicts middle-aged to late-stage dementia risk, or whether the association between component vascular risk factors and accidental dementia varies with age.”
Risk factors were measured at 5 time points: mid-55 years and again at 65, 70, 75, 80 years. The 10-year dementia follow-up period began at age 65. Participants from the time of risk factor measurement to the onset of dementia, death, or the last day when dementia was confirmed to be absent.
At the age of 55, the study consisted of 4,899 people (57.2% of women). By the age of 80, 2,386 non-dementia participants had data available (62.1% of women).
Age- and gender-adjusted risk factors measured at middle age (55 years) that are associated with a 10-year risk of dementia from age 65 include FSRP scores, diabetes, and systolic blood pressure. I was there. Factors related to the risk of the last 10 years from age 65 or 70 include FSRP score, antihypertensive drug use, diabetes, atrial fibrillation, non-stroke central vascular disease, and stroke. Later factors from age 75 or 80 were antihypertensive drug use, diabetes, atrial fibrillation, and stroke.
At most ages, adding a genetic risk score for Alzheimer’s disease slightly improved the identification of models using subcurve area (AUC). However, at age 70, the genetic risk score increased AUC from 0.58 to 0.65.
“Our findings show prioritized age-specific dementia risk, including 55 years, systolic blood pressure and diabetes, 65 years, non-stroke central vascular disease, 70 and 75 years, diabetes and stroke, and 80 years. We support the use of scores, diabetes, stroke and the use of antihypertensive drugs, “McGrath and co-authors write.
This study had some limitations. Framingham samples are predominantly Caucasian and the results may not apply to other populations. Survivors without dementia were included in the analysis at 5-year intervals, but people with a more severe vascular risk profile died during the study period, which may have affected the results. In addition, dementia was diagnosed using clinical criteria rather than biomarker-based criteria, and dementia subtypes were not evaluated.
This study was supported by the Irish Health Research Board, the Alzheimer Society, the National Institute of Cardiopulmonary Blood, the National Institute of Aging, and the National Institute of Neurological Disorders and Stroke.
Researchers have not reported disclosures related to the manuscript.
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