Cardiovascular health and dementia incidence among older adults in Latin America: Results from the 10/66 study

Abstract

Objectives Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. This study aimed to assess the longitudinal association between CVH and dementia in six Latin American countries. Methods We analyzed longitudinal data from the 10/66 study that included nondementia residents at baseline aged 65+ in six Latin American countries (n = 6447) and were followed up for 3 years. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risk regression to adjust for risk of death. Results The sample included 6.2% participants with poor (0‐5), 81.0% with moderate (6‐10), and 12.8% with ideal CVH (11‐14). At follow‐up, 9.4% had developed dementia and 13.1% had died. Compared with those with poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia in both the unadjusted (subhazard ratio for moderate, 0.77; ideal, 0.59) and adjusted models (moderate, 0.73; ideal, 0.66). Conclusion Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries.

Risk Factors for Incident Dementia Among Older Cubans

“…In line with previous studies that attributed a large part of the dementia risk to lifestyle factors ( 9 ), lifestyle factors, particularly physical activity, dominate the risk profiles in this cohort of Cuban older adults. Previous studies using data from the wider Latin American 10/66 cohort including data from Dominican Republic, Mexico, Peru, Puerto Rico, Venezuela and Cuba ( 11 ), have demonstrated that better scores on a cardiovascular health index (based on physical activity, smoking, alcohol, hypertension, obesity, cholesterol, glucose, and intake of meat, fish, fruits and vegetables) was associated with lower risk of dementia ( 30 ). The current study adds that, when each factor is viewed independently, some but not all of these factors are associated with dementia and the associations differ for the younger and older age groups.…”

Can dementia risk be reduced by following the American Heart Association's Life's Simple 7? A systematic review and dose-response meta-analysis

“…In total, the combined population consists of 287 058 participants, of which 8 006 had dementia, and 24 596 participants with repeated measurements for global cognitive decline. The selected studies were mostly conducted in Europe (Hessler et al, 2016;Samieri et al, 2018;Sabia et al, 2019;Liang et al, 2020;Malik et al, 2021;Speh et al, 2021) (n = 6) and North America (n = 8) (Pase et al, 2016;Vu et al, 2018;Peloso et al, 2020;Ogunmoroti et al, 2016;Perales-Puchalt et al, 2020;Guo et al, 2021;González et al, 2018;Thacker et al, 2014;Tin et al, 2022). The average age of included study participants at baseline was 60.0 years (standard deviation: 10.5 years).…”

“…Using categorical estimations, we derived the hazard ratios of dementia with 95%CI in relation to the CVH score from 11 studies (see Fig. 2, penal A) (Hessler et al, 2016;Vu et al, 2018;Peloso et al, 2020;Ogunmoroti et al, 2016;Samieri et al, 2018;Sabia et al, 2019;Liang et al, 2020;Malik et al, 2021;Perales-Puchalt et al, 2020;Guo et al, 2021;Thacker et al, 2014;Tin et al, 2022). Overall, a one-point increase in CVH score is associated with a 6% decrease in incident dementia (hazard ratio 0.94, 0.92-0.96, I 2 =94.98.04%).…”

“…Because of a limited number of selected studies and insufficient data for synthesis, the dose-response meta-analyses were only performed when dementia was treated as an outcome. We included ten studies that reported sufficient information for the non-linear dose-response analyses and applied the average CVH score (7-points) as a reference value (Hessler et al, 2016;Vu et al, 2018;Peloso et al, 2020;Ogunmoroti et al, 2016;Sabia et al, 2019;Liang et al, 2020;Malik et al, 2021;Perales-Puchalt et al, 2020;Guo et al, 2021;Tin et al, 2022). The dose-response curve (see Fig.…”

Cardiovascular contributions to dementia: beyond individual risk factors

“…For example, studies show that mid-life obesity may increase the risk of dementia but late-life obesity may be protective (Pase et al, 2017). Cardiovascular risk factors often co-occur, and recent studies show that cardiovascular factors may have a cumulative impact on the development of dementia (Perales et al, 2018, Perales-Puchalt et al, 2019. However, there remains a gap in the literature regarding whether the cumulative impact of specific cardiovascular risk factors on the development of dementia acts additively or synergistically.…”