Adults Diagnosed With Coronary Heart Disease Could Have Increased Risk of Dementia

Adults diagnosed with coronary heart disease, especially those diagnosed before age 45, could be at an increased risk of developing dementia, Alzheimer disease (AD), and vascular dementia later in life, according to results of a study published in the Journal of the American Heart Association.^1,2

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“Coronary heart disease has previously been associated with dementia risk in older adults, however, this is believed to be the first large-scale study examining whether the age of coronary heart disease onset may impact the risk of developing dementia later in life,” Fanfan Zheng, PhD, researcher in the School of Nursing at the Chinese Academy of Medical Sciences & Peking Union Medical College in Beijing, China, said in a press release. “In previous research, we found that adults experienced accelerated cognitive decline after new diagnoses of coronary heart disease.”¹

The investigators of the study aimed to determine whether there was a relationship between age of onset of coronary heart disease and the development of dementia. They used health record from a total of 432,667 adults with a median age of 57 years and 54.6% female from the UK Biobank, according to the press release. The data were accessed in May 2022 and analyzed from October 2022 to December 2022. Data about age of diagnosis and incident of dementia were collected over an average of 13 years, according to the press release.¹

Of the adults, 11.7% had coronary heart disease at the time of enrollment and through the follow-up period. There were 240 adults with coronary heart disease who were excluded due to missing data about diagnosis age. The analysis was adjusted for demographic factors, including age, sex, race, and education; lifestyle factors including smoking status, alcohol consumption, and exercise; and health factors including baseline body mass index, levels of low-density lipoprotein cholesterol, hypertension status, diabetes status, statins usage, and APOE4 gene status.¹

Among the individuals included in the study, there were 5876 cases of dementia, 2540 cases of AD, and 1220 cases of vascular dementia, according to press release. Individuals with coronary heart disease had higher risk of developing dementia from any cause, AD, and vascular dementia when compared to those who did not have coronary heart disease.¹

After adjusting for demographic and lifestyle factors, individuals with coronary heart disease had approximately a 35% increased risk of developing dementia, 13% increased risk of developing AD, and a 78% increased risk of developing vascular dementia. Additionally, the investigators found that early coronary heart disease onset was associated with a 35% increased risk, 29% increased risk, and 22% increased risk, respectively.¹

Furthermore, the risk of dementia was directly linked to the younger age of disease onset per 10-year decrease in age. Those who did have coronary heart disease before the age of 45 had a significantly increase risk of developing dementia compared to those who did not have coronary heart disease, according to the press release.¹

“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 in the press release. “As more [individuals] 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 [individuals] 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.”¹

References

1. Coronary heart disease before age 45 may increase risk of dementia later in life. News release. American Heart Association. November 29, 2023. Accessed December 20, 2023. https://newsroom.heart.org/news/coronary-heart-disease-before-age-45-may-increase-risk-of-dementia-later-in-life?preview=9cb6
2. Liang J, Li C, Gao D, Ma Q, et al. Association Between Onset Age of Coronary Heart Disease and Incident Dementia: A Prospective Cohort Study. J Am Heart Assoc. 2023;12(23):e031407. doi:10.1161/JAHA.123.031407