Cardiometabolic Diseases Double Dementia Risk, UK Biobank Study Finds

Drawing data from 287,748 participants in the UK Biobank, the researchers aimed to understand how having multiple CMDs impacts the likelihood of developing various forms of dementia, including all-cause dementia (ACD), Alzheimer’s disease (AD), and vascular dementia (VD). The study also explored potential biological mechanisms by examining inflammatory and metabolic biomarkers as mediators in these associations.

The key findings were as follows:

• Individuals with multiple cardiometabolic diseases (CMDs) were significantly more likely to develop dementia compared to those without CMDs.
• CMD multimorbidity was associated with over twice the risk of all-cause dementia (hazard ratio [HR]: 2.27).
• The risk of Alzheimer’s disease was nearly 1.5 times higher (HR: 1.49) in individuals with CMDs.
• The likelihood of developing vascular dementia was more than three times higher (HR: 3.70) among those with CMD multimorbidity.
• Subgroup analyses showed that the risk was particularly elevated in individuals younger than 60 years and women.
• Mediation analysis revealed that elevated blood glucose levels explained approximately 9.22% of the association between CMDs and dementia.
• Hemoglobin A1c contributed to 11.85% of this association.
• Neutrophil levels, reflecting inflammation, mediated about 2.43% of the link with all-cause dementia.
• These findings suggest that both metabolic and inflammatory pathways may contribute to the development of cognitive decline in individuals with CMDs.

Despite the robust findings, the researchers acknowledged several limitations. The data on CMDs and biomarkers were collected only at the beginning of the study, meaning changes in health status over time were not captured. Additionally, the classification of dementia subtypes, particularly vascular dementia, may have limited diagnostic accuracy in the UK Biobank database. The observational design of the study also means causality cannot be firmly established, although the long follow-up period of over 15 years adds credibility to the temporal relationship.

The authors emphasized the critical need for early monitoring and timely intervention in individuals with cardiometabolic conditions, particularly among those in midlife and women. They noted that effective management of key risk factors—such as elevated blood glucose levels and inflammation—could help lower the risk of developing dementia in later life. Furthermore, the authors recommended that future research should investigate the potential of anti-inflammatory and metabolic-targeting therapies as preventive strategies for dementia in high-risk populations.

Reference:

Zhang, J., Huang, X., Ling, Y. et al. Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank. BMC Public Health 25, 2397 (2025). https://doi.org/10.1186/s12889-025-23352-5