Heart Diseases and Long-Term Risk of Dementia and Alzheimer's Disease: A Population-Based CAIDE Study
Abstract
BACKGROUND: Many cardiovascular risk factors are shown to increase the risk of dementia and Alzheimer's disease (AD), but the impact of heart disease on later development of dementia is still unclear. OBJECTIVE: The aim of the study was to investigate the long-term risk of dementia and Alzheimer's disease (AD) related to midlife and late-life atrial fibrillation (AF), heart failure (HF), and coronary artery disease (CAD) in a population-based study with a follow-up of over 25 years. METHODS: Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study includes 2000 participants who were randomly selected from four separate, population-based samples originally studied in midlife (1972, 1977, 1982, or 1987). Re-examinations were carried out in 1998 and 2005-2008. Altogether 1,510 (75.5%) persons participated in at least one re-examination, and 127 (8.4%) persons were diagnosed with dementia (of which 102 had AD). RESULTS: AF in late-life was an independent risk factor for dementia (HR 2.61, 95% CI 1.05-6.47; p = 0.039) and AD (HR 2.54, 95% CI 1.04-6.16; p = 0.040) in the fully adjusted analyses. The association was even stronger among the apolipoprotein E (APOE) ε4 non-carriers. Late-life HF, but not CAD, tended to increase the risks as well. Heart diseases diagnosed at midlife did not increase the risk of later dementia and AD. CONCLUSION: Late-life heart diseases increase the subsequent risk of dementia and AD. Prevention and effective treatment of heart diseases may be important also from the perspective of brain health and cognitive functioning.
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In a small study of women referred for cardiac MRI, more atrial fibrosis was detected in women than in men using delayed-enhancement MRI.
“However, in a small study of women referred for cardiac MRI, more atrial fibrosis was detected in women than in men, using delayed-enhancement magnetic resonance imaging.142”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [142]
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Reduced Cardiovascular Functions in Patients with Alzheimer’s Disease
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“…results of our study, along with previous findings of brain hypoperfusion in AD patients and heart failure being a risk factor for AD [14, 15, 19–22], we put forward a hypothesis in which impaired cardiac function and vascular condition may lead to hypoperfusion, which further aggravates…”
Population-Based Cohort Study on Dementia Risk in Patients with Type 1 Diabetes Mellitus
Kuo, C., Lu, C., Chang, Y., & Li, C. (2018) · Neuroepidemiology · doi:10.1159/000486719 · Cited by 26 · see citing works
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“In contrast, another study showed that only late-life AF was associated with dementia [12].”
ResultIncreased risk of dementia in patients with genital warts: A nationwide cohort study in Taiwan
Lin, C., Chien, W., Chung, C., Chiang, C., Wang, W., Chang, H., Kao, Y., & Tzeng, N. (2020) · The Journal of Dermatology · doi:10.1111/1346-8138.15277 · Cited by 26 · see citing works
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“A Swedish national longitudinal study has shown that dementia patients had a higher prevalence of osteoporotic fractures [42].”
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“not in mid-life, was associated with a twofold increased risk of dementia [11].”
BackgroundInvestigation of multi-trait associations using pathway-based analysis of GWAS summary statistics
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“94 × 10 (3)), consistent with the previous finding that many cardiovascular risk factors are shown to increase the risk of dementia and ALZ [43].”
InfluentialAryal, R., & Patabendige, A. (2021) · Open Biology · doi:10.1098/rsob.200396 · Cited by 24 · see citing works
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“Heart disease, which is associated with all three components of the Bermuda Triangle [32, 33, 34], was also defined as a self-reported history of heart attack, angina, congestive cardiac failure and/or arrhythmia.”
BackgroundClinical Epidemiology, Evaluation, and Management of Dementia in Parkinson Disease
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Incident Atrial Fibrillation and Risk of Dementia in a Diverse, Community‐Based Population
Bansal, N., Zelnick, L. R., An, J., Harrison, T. N., Lee, M. S., Singer, D. E., Fan, D., & Go, A. S. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.122.028290 · Cited by 20 · see citing works
Age at Onset of Heart Failure and Subsequent Risk of Dementia
Zheng, F., Liang, J., Li, C., Ma, Q., Pan, Y., Zhang, W., Gao, D., Wang, Y., & Xie, W. (2023) · JACC Heart Failure · doi:10.1016/j.jchf.2023.08.006 · Cited by 20 · see citing works
Atrial Fibrillation and Risk of Dementia/Cognitive Decline.
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Selective Vulnerability of Cortical Border Zone to Microembolic Infarct
Bergui, M., Castagno, D., D’Agata, F., Cicerale, A., Anselmino, M., Ferrio, M. F., Giustetto, C., Halimi, F., Scaglione, M., & Gaïta, F. (2015) · Stroke · doi:10.1161/strokeaha.114.008194 · Cited by 20 · see citing works
“Anyway, the consequences of accumulation of large lesion loads may be more relevant in the long term and possibly coresponsible for increased cognitive decline in patients with sources of microemboli.(8,40) Table 3.”
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“The exact influence of CVD risk in APOE4 non-carriers is still unknown [12, 13].”
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“More specific associations between cardiac risk factors and both vascular and Alzheimer’s disease have also been demonstrated in large cohorts.(7,43,44) The systemic atherosclerotic arterial disease that occurs as a consequence of these vascular risk factors may have direct adverse impact on both cardiovascular and br…”
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“…longitudinal studies in other cohorts support that cardiovascular risk associates with accelerated cognitive decline ( Knopman et al., 2001; Rusanen et al., 2014; Samieri et al., 2018; SPRINT MIND Investigators for the SPRINT Research Group et al., 2019; W. Wang et al., 2022; Yaffe et al.,…”
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Is It Possible to Delay or Prevent Age-Related Cognitive Decline?
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Trajectory of Cardiogenic Dementia: A New Perspective
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Chronic cerebral hypoperfusion and dementia
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“[52] 2000 participants who were randomly selected from four separate, population-based samples originally studied in midlife 25 year follow up Clinical outcomes AF in late-life was an independent risk factor for dementia (HR 2.”
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Atrial Fibrillation and Deterioration in Cognitive Function
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“66 Also, Ganguli et al. 67 found that among all coronary heart diseases, only heart failure is a risk factor for MCI.”
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Predicting Alzheimer's Disease and Related Dementias in Heart Failure and Atrial Fibrillation
Manemann, S. M., Chamberlain, A. M., Bielinski, S. J., Jiang, R., Weston, S. A., & Roger, V. L. (2022) · The American Journal of Medicine · doi:10.1016/j.amjmed.2022.11.010 · Cited by 14 · see citing works
- Authors
- Rusanen, M., Kivipelto, M., Levälahti, E., Laatikainen, T., Tuomilehto, J., Soininen, H., & Ngandu, T.
- Affiliations
- University of Eastern Finland (FI)
- Finnish Institute for Health and Welfare (FI)
- University of Helsinki (FI)
- Karolinska Institutet (SE)
- Corresponding author
- Ngandu, Tiia
- Venue
- Journal of Alzheimer's Disease
- Publisher
- SAGE Publications
- Published
- 2014-08-11
- Volume
- 42
- Issue
- 1
- Pages
- 183-191
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- OpenAlex
- W1589554927
- Cited by
- 177
- References
- 0
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 17 · 2023: 17 · 2022: 9 · 2021: 14 · 2020: 23 · 2019: 19 · 2018: 21 · 2017: 12 · 2016: 14 · 2015: 12 · 2014: 5
- FWCI
- 10.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- Novo Nordisk Fonden (NNF12OC1016402, NNF11OC1014884)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- heart disease, dementia
- MeSH terms
- Age Factors, Aged, Alzheimer Disease, Atrial Fibrillation, Coronary Artery Disease, Dementia, Female, Finland, Follow-Up Studies, Heart Failure, Humans, Male, Risk, Risk Factors, Socioeconomic Factors, Cohort Studies, Apolipoprotein E4
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