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Home > Health Information > E-Newsletters > Heart Health 

Clear Heart, Clear Mind

Another risk factor for age-related dementia may have been uncovered.file_title

New research reveals that people with cardiovascular disease have an increased risk of developing dementia.

"It's exciting to me because I've been saying this for years, and they've done a nice clinical study," says Dr. Michael Freedman, director of the division of geriatrics at New York University Medical Center. "This is sort of how everybody has been treating patients, and it's confirming all that we knew."

The incidence of dementia in the United States is increasing as the population lives longer, yet little is known about its causes. Alzheimer's is the most common form of dementia in older people, followed by vascular dementia, which occurs when blood vessels to the brain become blocked, limiting blood supply and killing tissue.

"This study is exciting because it's getting closer to the idea of who to treat and what to treat," Freedman says.

Scientists already knew treatment of hypertension seems to delay the onset of Alzheimer's. Homocysteine, an amino acid found in the blood, is also a risk factor, and there is been some evidence that lowering cholesterol can delay the start of dementia.

The current study, presented at the recent annual meeting of the American Geriatric Society in Washington, D.C., was part of the larger Cardiovascular Health Study, which examined almost 6,000 people.

The researchers, led by Dr. Anne Newman, a geriatrician and associate professor of medicine and epidemiology at the University of Pittsburgh's School of Medicine, looked at a subset of that group: 3,602 people who had undergone additional cognitive testing.

As it turned out, those with cardiovascular disease had about a 30 percent increased risk of dementia, a result only partially explained by stroke. Those with peripheral artery disease, which affects areas outside the heart and lungs, had the highest risk of dementia.

The study did not look at interventions, but the implications are clear: treating cardiovascular disease may help prevent or delay the onset of different dementias.

Prevention of Heart Disease Is Key

"Although the relative risk was moderate, the high prevalence of cardiovascular disease, coupled with the high risk of dementia, in older adults would suggest that prevention of cardiovascular disease may be the most effective preventive measure we have for the prevention of dementia," Newman says in a statement.

"I see this in my office every day. A perfectly healthy 75-year-old with high blood pressure and cholesterol walks into my office. Do you treat it?" Freedman asks. "Just thinking logically, they're 75 and perfectly healthy, we'll just leave you alone. But, on the other hand, all the data is beginning to show that if you take a perfectly healthy 75-year-old and don't do anything, they have an increased risk of Alzheimer's by the time they're 85. If you treat them, you may push off the onset until they're in their 90s, and by then most of us aren't around. This is another bit of evidence that it makes a difference."

Always consult your physician for more information.

June 2002

Persons With Heart Disease Have Increased Risk of Dementia

Prevention of Heart Disease Is Key

More On Homocysteine's Effect on the Heart and Mind

Online Resources



More On Homocysteine's Effect on the Heart and Mind

Large elevations in a blood molecule, homocysteine, linked to heart disease also appear to significantly increase the risk of developing Alzheimer's disease and dementia.

A study published earlier this year shows homocysteine is crucial for many of the body's biochemical processes, and its levels increase with age. However, the findings, as published in the New England Journal of Medicine, also show that abnormally high levels of the molecule, and large increases over time, strongly predict who will develop dementia.

Taking folic acid and B vitamins can lower homocysteine, experts say, though there is no evidence yet to suggest these dietary measures can also reduce the risk of cognitive problems. However, researchers are now studying whether taking supplements can slow cognitive loss in those with mild and moderate Alzheimer's.

"We don't have that many risk or protective factors for Alzheimer's disease," says Neil Buckholtz, a dementia expert at the National Institute on Aging, which funded this study. "Age is still the major risk factor that we know about, which is clearly not modifiable."

Not all dementia is related to Alzheimer's; some results from vessel damage and other illnesses. However, the researchers found that elevated homocysteine appeared to boost the risk of cognitive problems associated with both the degenerative brain disorder and other forms of cognitive loss.

Always consult your physician for more information.



Online Resources       

American Heart Association

Journal of the American Medical Association (JAMA)

National Council on the Aging

National Heart, Lung, and Blood Institute (NHLBI)

National Institutes of Health (NIH)

National Institute on Aging

New England Journal of Medicine

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