Cardiometabolic multimorbidity accelerates cognitive decline and dementia progression

Abstract

Introduction: Cardiometabolic diseases (CMDs) have been individually associated with adverse cognitive outcomes, but their combined effect has not been investigated. Methods:A total of 2577 dementia-free participants 60 years of age or older were followed for 12 years to observe changes in cognitive function and to detect incident cognitive impairment, no dementia (CIND) and dementia. CMDs (including type 2 diabetes, heart disease, and stroke) were assessed at baseline through medical records and clinical examinations. Cardiometabolic multimorbidity was defined as the presence of two or more CMDs. Data were analyzed using multi-adjusted linear mixed-effects models, Cox regression, and Laplace regression.Results: CMD multimorbidity was associated with cognitive decline, CIND (hazard ratio [HR] 1.73; 95% confidence interval CI 1.23 to 2.44), and its progression to dementia (HR 1.86; 95% CI 1.17 to 2.97). CMD multimorbidity accelerated the onset of CIND by 2.3 years and dementia by 1.8 years.Conclusions: CMD multimorbidity accelerates cognitive decline and increases the risk of both CIND and its conversion to dementia.

Time‐dependent impact of type 2 diabetes mellitus on incident prodromal Alzheimer disease: A longitudinal study in 1395 participants

“…Second, the presence or absence of other comorbid diseases or risk factors is another crucial factor in the association between T2DM and AD. Prior research has revealed that comorbid cardiometabolic disease (including type 2 diabetes, heart disease, and stroke) multimorbidity increased the risk of both MCI and all-cause dementia [29][30][31][32]; this is consistent with our results in this study. Other studies suggested that comorbidity burden (ac- fect the brain's energy supply and metabolism, and APOE is also a metabolism-related protein.…”

Developmental Trajectories and Predictors of Incident Dementia among Elderly Taiwanese People: A 14-Year Longitudinal Study

“…Regarding comparisons between the three distinct trajectory groups, our study found that those diagnosed with hypertension, stroke, coronary heart disease, heart failure, and chronic obstructive pulmonary disease had increased odds for being classified into the high- and moderate-incidence groups. The findings of the current study are comparable to those of previous studies [ 22 , 23 , 24 , 25 ]. These cardiovascular diseases may cause physical disability and cognitive impairment in older adults [ 22 ].…”

“…These cardiovascular diseases may cause physical disability and cognitive impairment in older adults [ 22 ]. Moreover, accelerated cognitive decline and progression of dementia might be independently enhanced by cardiometabolic multimorbidity [ 23 , 24 , 25 ]. In addition, chronic obstructive pulmonary disease can be used as a surrogate marker for smoking behavior [ 26 ], which also has an impact on cognitive functioning [ 27 ].…”

Cardiometabolic multimorbidity and incident dementia: the Swedish twin registry

“…T2D, 27 HD, 28 , 29 and stroke 30 are widely recognized dementia risk factors, but only recently has the combined impact of multiple CMDs on dementia risk been explored. Previous studies from our group have shown that the risk of both cognitive impairment 8 and dementia 7 increases with a growing number of co-morbid CMDs (including T2D, HD, and stroke), using data from the Swedish National Study on Aging and Care—Kungsholmen (SNAC-K). In line with this, a recent study using data from the UK Biobank also reported a monotonic increase in dementia risk with one, two, and three co-morbid CMDs (including T2D, myocardial infarction, and stroke).…”