Cardiovascular disease, associated risk factors, and risk of dementia: An umbrella review of meta-analyses

Abstract

IntroductionCardiovascular diseases (CVDs) have been associated with an increased risk of dementia; yet the evidence is mixed. This review critically appraises and synthesises current evidence exploring associations between dementia risk and CVD and their risk factors, including coronary heart disease, heart failure, atrial fibrillation, hypertension, hyperlipidaemia, and arterial stiffness.MethodsMEDLINE, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews with meta-analyses investigating the association between at least one of the CVDs of interest and dementia risk. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews was used to assess methodological quality.ResultsTwenty-five meta-analyses published between 2007 and 2021 were included. Studies largely consisted of cohorts from North America and Europe. Findings were variable, with coronary heart disease, heart failure, and atrial fibrillation consistently associated with increased risk for all-cause dementia, but results were inconsistent for Alzheimer's disease. Hypertension was more frequently associated with dementia during mid-life compared to late life. Findings concerning cholesterol were complex, and while results were inconsistent for low-density lipoprotein cholesterol and total cholesterol, there appeared to be no associations between triglycerides and high-density lipoprotein cholesterol. All meta-analyses investigating hypercholesterolaemia showed significant increases in dementia risk. There was a paucity of research on the association between arterial stiffness and dementia risk.ConclusionTargeted CVD dementia prevention strategies could reduce dementia prevalence. Future research should determine the underpinning mechanisms linking heart and brain health to determine the most effective strategies for dementia risk reduction in CVD populations.

Association of dietary and nutritional factors with cognitive decline, dementia, and depressive symptomatology in older individuals according to a neurogenesis-centred biological susceptibility to brain ageing

“…Importantly, an excess of high-fat protein intake, such as red meat, increases the risk of cardiovascular diseases and diabetes [ 46 ], an outcome not observed for poultry consumption [ 47 ]. This may explain why high consumption of red meat, in particular, is not associated with reduced dementia risk [ 48 ]. Additionally, preclinical studies indicate that diets high in saturated fat can heighten oxidative stress, neuroinflammation, and altered HN [ 49–52 ]—changes all associated with dementia [ 5 , 53 , 54 ].…”

Dissecting unique and common variance across body and brain health indicators using age prediction

“…Changes in blood lipids, adipose and muscle tissue distribution, blood pressure, heart rate, hand grip strength, and anthropometric measures such as body mass index (BMI) and waist‐to‐hip ratio are all associated with ageing (Massy‐Westropp et al, 2011 ; Mielke et al, 2010 ; Rodgers et al, 2019 ; Sebastiani et al, 2017 ). Despite these measures being classified as markers of normal body function rather than disease‐specific biomarkers, recent studies have highlighted their utility for risk detection and disease monitoring across cardiovascular disease and dementia (Brain et al, 2023 ). For example, research has suggested that dysregulation in lipid metabolism in Alzheimer's disease may predict cognitive decline (Wong et al, 2017 ).…”

Dissecting unique and common variance across body and brain health indicators using age prediction

“…Changes in blood lipids, adipose and muscle tissue distribution, blood pressure, heart rate, hand grip strength, and anthropometric measures such as body mass index (BMI) and waist-to-hip ratio (WHR) are all associated with ageing (Massy-Westropp et al, 2011; Mielke et al, 2010; Rodgers et al, 2019; Sebastiani et al, 2017). Despite these measures being classified as markers of normal body function rather than disease-specific biomarkers, recent studies have highlighted their utility for risk detection and disease monitoring across cardiovascular disease and dementia (Brain et al, 2023). For example, research has suggested that dysregulation in lipid metabolism in Alzheimer’s disease may predict cognitive decline (Wong et al, 2017).…”

“…Despite these measures being classified as markers of normal body function rather than disease-specific biomarkers, recent studies have highlighted their utility for risk detection and disease monitoring across cardiovascular disease and dementia (Brain et al, 2023). For example, research has suggested that dysregulation in lipid metabolism in Alzheimer's disease may predict cognitive decline (Wong et al, 2017).…”