Heart Risks at Midlife Signal Dementia Down the Road

People who have high blood pressure or diabetes at mid-life are more likely to develop dementia as they get older, according to a new study presented at the 2017 International Stroke Conference in Houston, Texas.

An ongoing study that has followed 15,744 people in 4 US communities since 1987 is the latest to find common links between the indicators of heart disease and dementia. “The health of your vascular system in midlife is really important to the health of your brain when you are older,” said Rebecca F. Gottesman, MD, PhD, of Johns Hopkins University, in a statement.

Dementia developed in 1516 people in the study, and researchers found that the risk of developing the cognitive disorder later in life was:

• 77% higher among those with diabetes
• 41% higher among those smoking at midlife than those who did not smoke
• 39% higher in people with high blood pressure (140/90 mm Hg or higher)
• 31% higher in people with prehypertension (120/90 mm Hg to 139/89 mm Hg)

The link between diabetes and dementia was so strong that it could predict who would get Alzheimer’s disease as much as a known genetic connection, Gottesman said. Risks were higher among men, and smoking and carrying a genetic link raised risks more for whites than among African Americans, the study found.

The diabetes connection is not surprising, given the growing body of work showing the connection between this condition and cognitive decline, which are both linked to insulin resistance. As reported last year in Evidence-Based Diabetes Management^TM (EBDM^TM), Alzheimer’s symptoms can be similar to those of vascular dementia, and can result from the effects of type 2 diabetes on the brain.

“There’s a growing body of evidence that Alzheimer’s disease is, at its core, a condition defined by insulin resistance in the brain. The brain is the target of a particular kind of diabetes that some people call, type 3 diabetes. This form of diabetes can obviously occur independently of type 2 diabetes, as many people with Alzheimer’s disease do not have type 2 diabetes, but it also looks very likely that the 2 diseases can arise from the same causes, or that type 2 diabetes can either trigger or worsen Alzheimer’s disease in people who are otherwise prone to it,” said Suzanne de la Monte, MD, MPH, a professor of pathology, laboratory medicine and neurosurgery, at Brown University, told EBDM in an interview.

Researchers in this latest study emphasized that if the risks of dementia increase with indicators of heart disease, they can be reduced as well with healthier diets and exercise to lower blood pressure.

“If you knew you carried the gene increasing Alzheimer’s risk, you would know you were predisposed to dementia, but people don’t necessarily think of heart disease risks in the same way,” Gottesman said. “If you want to protect your brain as you get older, watch your weight, and go to the doctor so diabetes and high blood pressure can be detected and treated.”