Scott Buzby , 2025-05-05 13:28:00
Key takeaways:
- Elevated genetic and lifestyle risk for CAD was tied to increased risk for dementia.
- Lifestyle intervention may improve risk for dementia, regardless of genetic risk for CAD.
A heart-healthy lifestyle may reduce risk for dementia, even for people with elevated genetic risk for coronary artery disease, according to new data published in Circulation.
“CAD and dementia are two of the leading causes of death and disability worldwide, accounting for an estimated annual burden of 9 million and 2 million deaths, respectively. Both conditions occur as the result of separate and complex disease processes arising from diverse pathogeneses, but accumulating evidence suggests that each may share common, and at times potentially modifiable, underlying risk factors that act to simultaneously increase the risk of both diseases,” Arisa Sittichokkananon, of the Princess Srisavangavadhana College of Medicine at Chulabhorn Royal Academy in Bangkok, and colleagues wrote. “No study to date has investigated the potential for shared underlying genetic pathways to simultaneously contribute to the pathogenesis of both diseases or investigated the impact that healthy lifestyle behaviors earlier in the lifespan may have on different dementia outcomes.”
Elevated genetic and lifestyle risk for CAD was tied to increased risk for dementia. Image: Adobe Stock
The present study included data from 365,782 participants in the UK Biobank who were free from dementia for at least 5 years after initial assessment.
Genetic risk for CAD was assessed using genome-wide polygenic risk scores and potential lifestyle-based dementia risk attenuation was evaluated using a modified American Heart Association’s Life’s Essential 8 lifestyle risk score.
The AHA Life’s Essential 8 lifestyle risk score is used to measure the impact of lifestyle on heart health using eight biological and behavioral variables: BMI, lipids, blood glucose, BP, diet, physical activity, smoking status and sleep duration.
The primary outcomes were all-cause dementia, Alzheimer’s disease and vascular dementia.
During a median of nearly 14 years of follow-up, 8,870 incidents of all-cause dementia were reported.
The researchers observed that elevated genetic risk scores and lifestyle risk scores for CAD were respectively associated with elevated risk for all-cause dementia (HR per standard deviation [SD] increase in genetic risk score = 1.1; 95% CI, 1.08-1.12; P < .001; HR per SD increase in lifestyle risk score = 1.04; 95% CI, 1.02-1.06; P = .006).
Elevated genetic and lifestyle risk for CAD was primarily attributed to risk for vascular dementia (HR for genetic risk score = 1.16; 95% CI, 1.11-1.21; P < .001; HR for lifestyle risk score = 1.15; 1.09-1.22; P < .001), whereas Alzheimer’s disease had a moderate association with genetic risk for CAD alone (HR = 1.09; 95% CI, 1.06-1.13; P < .001), according to the study.
The researchers stated that lifestyle risk score for CAD had an additive impact, rather than interactive effect, on genetic risk scores, with participants in the highest tertiles for both genetic and lifestyle risk for CAD having significantly elevated risk for developing vascular dementia compared with those in the lowest tertiles of each (HR = 1.71; 95% CI, 1.39-2.11; P < .001).
Risk for vascular dementia was attenuated 40% to 50% among participants with low lifestyle risk scores for CAD at baseline, regardless of underlying genetic risk for CAD (P for all < .001), according to the study.
“Our findings suggest that an underlying genetic risk for coronary artery disease is associated with both an increased risk of cerebrovascular damage in midlife to late life and an increased risk of vascular dementia in long-term follow-up,” the researchers wrote. “Healthy lifestyle behaviors in the mid- to late-life period may attenuate this risk regardless of genetic predisposition, particularly in individuals who may be at risk of developing dementia caused by an underlying vascular pathology.”
