Being obese, smoking, high blood pressure, high cholesterol, and diabetes are well
known cardiovascular risk factors. Their presence in mid-life is associated with an
increased risk of the amyloid plaques associated with dementia later in life.
A study published in the JAMA in 2017 considered the links between brain amyloid
and the following cardiovascular risk factors: body mass index ≥30, current smoking,
hypertension, diabetes, and total cholesterol ≥200 mg/dl.56 57 The study found
that over an average of nearly 24 years, compared to those with no midlife vascular
risk factors, the odds of elevated brain amyloid with one vascular risk factor present
was 88% higher and with two or more vascular risk factors the risk was nearly tripled
at 2.88 times. The strongest association between risk factors and brain amyloid
was found among study subjects who were obese at midlife. They were twice as
likely to have elevated brain amyloid in later life as those of normal weight. Latelife
vascular risk factors were not associated with late-life brain amyloid deposition.
The study authors concluded that their findings are consistent with a role for vascular
disease in the development of Alzheimer disease.
Additional evidence of the role of CVD in dementia comes from a study in the
JAMA that found that people with optimal cardiovascular risk factors are at substantially
reduced risk for dementia. In the study, people ages 65 and older
who did not have dementia or cardiovascular disease underwent neuropsychological
testing for dementia every two or three years for an average of almost nine years.
The seven optimal risk factors/metrics were those found by the American Heart
Association to be associated with optimal cardiovascular health:
• Not smoking
• Healthy weight, body mass index (BMI) less than 25
• Regular physical activity
• Healthy diet, eating fish twice a week or more and fruits and vegetables at least
three times a day
• Total cholesterol (untreated) below 200 mg/dL
• Fasting blood sugar (untreated), below 100 mg/dL
• Blood pressure (untreated), below 120/80 mm Hg.
On average, the presence of each optimal factor was associated with a 10% lower
risk of developing dementia. Over the course of the study, the incidence rate of
dementia per 100 person-years was 1.56 for those with no to two optimal risk factors,
1.23 for those with three or four optimal factors, and 0.83 for those with five
to seven optimal factors. Only 7% of people had five to seven optimal factors, but
their incidence of dementia was about half that of those with no to two optimal risk
factors. The researchers controlled for education, socioeconomic status, and the
presence of the APOE-4 gene that increases dementia risk.
The study authors concluded that “In this cohort of older adults, increased numbers
of optimal cardiovascular health metrics and a higher cardiovascular health score
were associated with a lower risk of dementia and lower rates of cognitive decline.
These findings may support the promotion of cardiovascular health to prevent risk
factors associated with cognitive decline and dementia.”
Even among young adults with a mean age of 25, cardiovascular health factors affect
brain vascular structure, function, and brain tissue integrity, as visualized with
magnetic resonance imaging. Already at this young age, optimal cardiovascular
health was associated with better cerebral perfusion and fewer subclinical brain
lesions—thus emphasizing the importance of avoiding cardiovascular risk factors.
Cardiac health is also linked to Parkinson’s disease, a condition characterized by
problems with disruption of movement, disruption of cognitive functions, and often
dementia. About 1 million Americans are living with Parkinson’s disease. A study
in South Korea considered if the presence of the metabolic syndrome was linked to
Parkinson’s disease. The metabolic syndrome is defined as the presence of three
or more of the following: abdominal obesity, high blood pressure, high blood sugar,
high triglycerides, and low HDL-C. The analysis indicated that individuals with
metabolic syndrome had a 24% higher risk of incident Parkinson’s disease, and
each metabolic syndrome component was positively associated with Parkinson’s
This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.