Dementia may arrive a decade earlier in men at high risk for heart disease, study finds

Men at risk for heart disease may develop dementia up to a decade earlier than similarly at-risk women, a new study found.

“The influence of cardiovascular disease on dementia in men a decade before the females is not known before,” said lead study author Dr. Paul Edison, professor of neuroscience at Imperial College London, in an email.

“This is novel finding with significant health implications.”

Cardiovascular diseases are the leading cause of death in the world, according to the World Health Organization, and heart disease has been the No. 1 killer in the United States for more than 100 years.

Heart disease risk factors include obesity, diabetes, high blood pressure and cholesterol, along with smoking, drinking too much alcohol and not getting proper exercise and adequate sleep, according to the US Centers for Disease Control and Prevention. All these conditions can lead to small vessel disease, which can affect oxygen delivery to the brain.

The damaging impact of cardiovascular risk was just as evident in people who didn’t carry the APOE ε4 gene as those who did carry the gene, the study found. The APOE ε4 gene is considered the strongest risk factor for the future development of Alzheimer’s disease in people over the age of 65. Having one or even two copies of the gene does not guarantee that Alzheimer’s will develop, experts say, so maintaining a healthy lifestyle may be critically important.

“Modifying cardiovascular risk may prevent Alzheimer’s disease,” said Edison, who is also the head of the Memory Research Centre at Imperial College London. “Our results suggest that this should be done a decade earlier in males than in females irrespective of whether they carry the risk genes (APOE ε4) for Alzheimer’s disease.”

The study’s findings are consistent with existing literature that shows higher levels of cardiovascular risk may be associated with negative neurocognitive outcomes, said epidemiologist Jingkai Wei, an assistant professor of family medicine at the University of Texas Health Science Center at Houston, in an email.

Wei, who was not involved in the new study, did similar research and found a decade of living with heart risk was linked to poor performance on cognitive tests measuring executive function, processing speed and immediate and delayed memory in men and women over 60.

The new study’s results supplement his own and suggest “poorer cardiovascular health is associated with both poorer cognitive function and brain pathology, which are both predictive of dementia,” Wei said.