Cardiovascular Risk and Cognitive Function in Middle-Aged and Older Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Tarraf, Wassim; Kaplan, Robert C.; Daviglus, Martha L.; Gallo, Linda C.; Schneiderman, Neil; Penedo, Frank J.; Perreira, Krista M.; Lamar, Melissa; Chai, Albert; Vásquez, Priscilla M.; González, Héctor M.

doi:10.3233/jad-190830

“…This is consistent with previous studies which reported that post-stroke dementia is more prevalent in men [35]. In large-scale populationbased cohort studies on the association of cardiovascular risk [36] and blood pressure pattern [37] with cognitive function, researchers have consistently reported that mid-life vascular disease has a more substantial effect on dementia onset. Our ndings highlight the importance of midlife as a critical period for later cognitive function.…”

Section: Discussionsupporting

confidence: 92%

Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: A nationwide population-based cohort study

Jang

¹

,

Kang

²

,

Myung

³

et al. 2021

Preprint

1

0

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Background: Dementia is a progressive neurocognitive disease with a substantial social burden. No apparent breakthroughs in treatment options have emerged so far; thus, disease prevention is essential for at-risk populations. Depression and cerebrovascular disease (CVD) are independent risk factors for dementia, but no studies have examined their interaction effect on dementia risk. This study aimed to identify the association of depression and CVD with the risk of dementia and evaluate whether dementia risk among patients with comorbid depression and CVD is higher than the sum of the individual risk due to each condition.Methods: A population-based cohort study was conducted to analyze the Korean National Health Insurance Service-National Sample Cohort data of all individuals over 50 years of age. Individuals who had not been diagnosed with dementia at baseline were included and followed up from January 1, 2005 to December 31, 2013. A time-varying Cox proportional hazard regression model adjusted for potential confounding factors was used for the analysis. The interaction between depression and CVD was estimated based on attributable proportion (AP), relative excess risk due to interaction (RERI), synergy index (SI), and multiplicative-scale interaction.Results: A total of 242,237 participants were included in the analytical sample, of which 12,735 (5.3%) developed dementia. Compared to that for participants without depression or CVD, the adjusted hazard ratio for the incidence of dementia for those with depression alone was 2.35 (95% confidence interval [CI]: 2.21-2.49), CVD alone was 3.25 (95% CI: 3.11-3.39), and comorbid depression and CVD was 5.02 (95% CI: 4.66-5.42). The additive interaction between depression and CVD was statistically significant (AP: 0.08, 95% CI: 0.01-0.16; RERI: 0.42, 95% CI: 0.03-0.82; SI: 1.12, 95% CI: 1.01-1.24). The multiplicative interaction was significant too, but effect was negative (0.66, 95% CI: 0.60-0.73).Conclusions: In this population-based nationwide cohort with long-term follow-up, depression and CVD were associated with an increased risk of dementia, and their coexistence additively increased dementia risk more than the sum of the individual risks.

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“…This is consistent with previous studies which reported that post-stroke dementia is more prevalent in men [50]. In large-scale populationbased cohort studies on the association of cardiovascular risk [51] and blood pressure pattern [52] with cognitive function, researchers have consistently reported that mid-life vascular disease has a more substantial effect on dementia onset. Our ndings highlight the importance of midlife as a critical period for later cognitive function.…”

Section: Discussionsupporting

confidence: 92%

Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: A nationwide population-based cohort study

Jang

¹

,

Kang

²

,

Myung

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Dementia is a progressive neurocognitive disease with a substantial social burden. No apparent breakthroughs in treatment options have emerged so far; thus, disease prevention is essential for at-risk populations. Depression and cerebrovascular disease (CVD) are independent risk factors for dementia, but no studies have examined their interaction effect on dementia risk. This study aimed to identify the association of depression and CVD with the risk of dementia and evaluate whether dementia risk among patients with comorbid depression and CVD is higher than the sum of the individual risk due to each condition.Methods: A population-based cohort study was conducted to analyze the Korean National Health Insurance Service-National Sample Cohort data of all individuals over 50 years of age. Individuals who had not been diagnosed with dementia at baseline were included and followed up from January 1, 2005 to December 31, 2013. A time-varying Cox proportional hazard regression model adjusted for potential confounding factors was used for the analysis. The interaction between depression and CVD was estimated based on attributable proportion (AP), relative excess risk due to interaction (RERI), synergy index (SI), and multiplicative-scale interaction.Results: A total of 242,237 participants were included in the analytical sample, of which 12,735 (5.3%) developed dementia. Compared to that for participants without depression or CVD, the adjusted hazard ratio for the incidence of dementia for those with depression alone was 2.35 (95% confidence interval [CI]: 2.21-2.49), CVD alone was 3.25 (95% CI: 3.11-3.39), and comorbid depression and CVD was 5.02 (95% CI: 4.66-5.42). The additive interaction between depression and CVD was statistically significant (AP: 0.08, 95% CI: 0.01-0.16; RERI: 0.42, 95% CI: 0.03-0.82; SI: 1.12, 95% CI: 1.01-1.24). The multiplicative interaction was significant too, but effect was negative (0.66, 95% CI: 0.60-0.73).Conclusions: In this population-based nationwide cohort with long-term follow-up, depression and CVD were associated with an increased risk of dementia, and their coexistence additively increased dementia risk more than the sum of the individual risks.

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“…This is consistent with previous studies which reported that post-stroke dementia is more prevalent in men [ 35 ]. In large-scale population-based cohort studies on the association of cardiovascular risk [ 36 ] and blood pressure pattern [ 37 ] with cognitive function, researchers have consistently reported that mid-life vascular disease has a more substantial effect on dementia onset. Our findings highlight the importance of midlife as a critical period for later cognitive function.…”

Section: Discussionmentioning

confidence: 99%

Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: a nationwide population-based cohort study

Jang

¹

,

Kang

²

,

Myung

³

et al. 2021

View full text Add to dashboard Cite

Background Dementia is a progressive neurocognitive disease with a substantial social burden. No apparent breakthroughs in treatment options have emerged so far; thus, disease prevention is essential for at-risk populations. Depression and cerebrovascular disease (CVD) are independent risk factors for dementia, but no studies have examined their interaction effect on dementia risk. This study aimed to identify the association of depression and CVD with the risk of dementia and evaluate whether dementia risk among patients with comorbid depression and CVD is higher than the sum of the individual risk due to each condition. Methods A population-based cohort study was conducted to analyze the Korean National Health Insurance Service-National Sample Cohort data of all individuals over 50 years of age. Individuals who had not been diagnosed with dementia at baseline were included and followed up from January 1, 2005, to December 31, 2013. A time-varying Cox proportional hazard regression model adjusted for potential confounding factors was used for the analysis. The interaction between depression and CVD was estimated based on the attributable proportion (AP), relative excess risk due to interaction (RERI), synergy index (SI), and multiplicative-scale interaction. Results A total of 242,237 participants were included in the analytical sample, of which 12,735 (5.3%) developed dementia. Compared to that for participants without depression or CVD, the adjusted hazard ratio for the incidence of dementia for those with depression alone was 2.35 (95% confidence interval [CI] 2.21–2.49), CVD alone was 3.25 (95% CI 3.11–3.39), and comorbid depression and CVD was 5.02 (95% CI 4.66–5.42). The additive interaction between depression and CVD was statistically significant (AP—0.08, 95% CI 0.01–0.16; RERI—0.42, 95% CI 0.03–0.82; SI—1.12, 95% CI 1.01–1.24). The multiplicative interaction was significant too, but the effect was negative (0.66, 95% CI 0.60–0.73). Conclusions In this population-based nationwide cohort with long-term follow-up, depression and CVD were associated with an increased risk of dementia, and their coexistence additively increased dementia risk more than the sum of the individual risks.

show abstract

Cardiovascular Risk and Cognitive Function in Middle-Aged and Older Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Cited by 33 publications

References 46 publications

Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: A nationwide population-based cohort study

Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: A nationwide population-based cohort study

Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: A nationwide population-based cohort study

Additive interaction of mid- to late-life depression and cerebrovascular disease on the risk of dementia: a nationwide population-based cohort study

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