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Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4414 (Published 07 August 2019) Cite this as: BMJ 2019;366:l4414

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The determinants of cognitive decline and dementia

Linked BMJ Opinion

The implications of cardiovascular health for dementia

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Re: Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study

We read with interest the recent study by Sabia et al. showing that adherence to Life’s Simple 7 ideal cardiovascular health recommendations in midlife (age 50 years) was associated with a lower dementia risk in later life, with a 1 point increment in the cardiovascular health score being associated with an 11% reduction in dementia risk. Our similar analysis (2018[1]), provides evidence that adherence to Life’s Simple 7 ideal cardiovascular health recommendations [2] at ages 60 to 69 years was also associated with a lower dementia risk.

Specifically, we examined the cardiovascular health profiles of 60 to 69 year olds at baseline with the incidence of a number of ageing outcomes, in two large cohorts in the UK, over a maximum follow-up of 10 years[1]. Comparable to Sabia’s study, we found a 33% reduction in risk of incident hospital diagnosed dementia in those with ideal compared to low cardiovascular risks in 181,820 healthy volunteers from the UK Biobank. These combined findings highlight that public health interventions to improve cardiovascular health are likely to be beneficial in terms of dementia risk reduction both in midlife and also in older age groups.

References
1. Atkins JL, Delgado J, Pilling LC, et al. Impact of Low Cardiovascular Risk Profiles on Geriatric Outcomes: Evidence From 421,000 Participants in Two Cohorts. Journals Gerontol Ser A. 2019;15(74(3)):350-357. doi:10.1093/gerona/gly083
2. Lloyd-Jones DM, Hong Y, Labarthe D, et al, American Heart Association Strategic Planning Task Force and Statistics Committee. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation 2010;121:586-613. doi:10.1161/CIRCULATIONAHA.109.192703

Competing interests: No competing interests

23 August 2019
Janice L Atkins
Research Fellow
Joao Delgado, David Melzer
University of Exeter Medical School
RILD Building, RD&E Wonford, Barrack Road, Exeter EX2 5DW, UK