Younger onset age of coronary heart disease before age 45 may raise risk of dementia later in life: JAHA

“What surprised us most was the linear relationship between age of coronary heart disease onset and dementia. This shows the huge detrimental influence of premature coronary heart disease on brain health,” Zheng said. “As more people live longer and are diagnosed with coronary heart disease at a younger age, it’s likely there will be a large increase in the number of people living with dementia in years to come. Health care professionals should be aware of individuals diagnosed with coronary heart disease at a young age. The next step is to determine whether modifying cardiovascular risk early in life will promote better brain health later in life.”

Study details and background:

• The UK Biobank is a large, biomedical database and research resource with health records of about 500,000 adults-enrolled from 2006 until 2010-who live in the U.K and received health care through the U.K.’s National Health Service. The researchers accessed the data in May 2022 and analyzed health records through October to December 2022.
• The researchers analyzed health records for a total of 432,667 adults (average age of 57 years when they became participants in the UK Biobank; 54.6% were female); 11.7% -50,685 adults-had coronary heart disease at time of enrollment and through the follow-up period. 240 adults who had coronary heart disease were excluded due to missing data about the age at which they were diagnosed with CHD.
• The researchers adjusted the analysis for demographic factors including age, sex, race and education. They also adjusted for lifestyle factors, including smoking status, alcohol consumption and whether participants engaged in moderate or vigorous exercise for over 10 minutes at least twice per week. Health factors considered included baseline body mass index; levels of low-density lipoprotein cholesterol; hypertension status; diabetes status; use of statins; and if they were a carrier for the APOE4 gene, which increases an individual’s risk of developing Alzheimer’s.
• Data on age of coronary heart disease onset and subsequent incident dementia were collected over an average of 13 years of follow-up.
• The researchers controlled for confounding bias, which suggests associations where they may not exist. They then evaluated the association between coronary artery disease onset in different age groups and the development of dementia. 50,445 of the participants with coronary heart disease were divided into three groups based on age of heart disease onset-before age 45; 45 to 59; and 60 and older then matched to counterparts who did not have coronary heart disease to gauge the possible relationship between coronary heart disease and dementia.

According to the American Heart Association’s 2023 Statistical Update, coronary heart disease caused 382,820 deaths in 2020. The estimated rate of dementia (alone, not including Alzheimer’s) in U.S. adults, 65 years of age and older, was 10.5% in 2012, with a rate of 7.3% in males and 12.9% in females, according to the Aging, Demographics and Memory Study, which is a supplemental study of the long-running Health and Retirement Study in the U.S.

Reference:

Jie Liang, Chenglong Li, Darui Gao, Qian Ma, Yongqian Wang, Yang Pan, Wenya Zhang, Wuxiang Xie and Fanfan Zheng, Association Between Onset Age of Coronary Heart Disease and Incident Dementia: A Prospective Cohort Study, https://doi.org/10.1161/JAHA.123.031407.