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Midlife vascular risk factors and risk of incident dementia: Longitudinal cohort and Mendelian randomization analyses in the UK Biobank.

Alzheimers Dement. 2021 Mar 22. doi: 10.1002/alz.12320. Epub ahead of print. PMID: 33749976.

Authors/Editors: Malik R, Georgakis MK, Neitzel J, Rannikmäe K, Ewers M, Seshadri S, Sudlow CLM, Dichgans M.
Publication Date: 2021

Abstract

Introduction
Midlife clustering of vascular risk factors has been associated with late‐life dementia, but causal effects of individual biological and lifestyle factors remain largely unknown.

Methods
Among 229,976 individuals (mean follow‐up 9 years), we explored whether midlife cardiovascular health measured by Life's Simple 7 (LS7) is associated with incident all‐cause dementia and whether the individual components of the score are causally associated with dementia.

Results
Adherence to the biological metrics of LS7 (blood pressure, cholesterol, glycemic status) was associated with lower incident dementia risk (hazard ratio = 0.93 per 1‐point increase, 95% confidence interval [CI; 0.89–0.96]). In contrast, there was no association between the composite LS7 score and the lifestyle subscore (smoking, body mass index, diet, physical activity) and incident dementia. In Mendelian randomization analyses, genetically elevated blood pressure was associated with higher risk of dementia (odds ratio = 1.31 per one‐standard deviation increase, 95% CI [1.05–1.60]).

Discussion
These findings underscore the importance of blood pressure control in midlife to mitigate dementia risk.

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