Weight Loss, Lipid Changes Could Point Towards Dementia Risk
Poor cardiometabolic health is associated with cognitive impairment in later life, but there is no clear association between cardiometabolic trajectories and early markers.
Weight loss and lipid changes could be an indicator for underlying cognitive impairments, according to the results of a study published in JAMA Network Open.1 Poor cardiometabolic health is associated with cognitive impairment in later life, but there is no clear association between cardiometabolic trajectories and early markers of dementia.
The association shows that cardiometabolic risk factors should be investigated deeper to further understand the association. | Image Credit: jarun011 | stock.adobe.com
In a prior study published in The Lancet, dementia risk was associated with high cardiometabolic multimorbidity, which was 3 times greater than genetic risk.2 Patients who had a high genetic risk in addition to cardiometabolic multimorbidity had increased odds of developing dementia. The association shows that cardiometabolic risk factors should be investigated deeper to further understand the association.
There have been a few studies exploring changes in body mass index (BMI) and dementia developed later in life. However, the sample sizes and reliance on health records were limited. The study authors said that prior research explored various cardiometabolic factors, including blood pressure, glucose, and lipid levels, and the association with dementia. Evidence on addressing trajectories prior to dementia diagnosis has also been limited; therefore, investigators used data from a large cohort of community-dwelling individuals 65 years and older to determine the trajectories of cardiometabolic factors in later life.1
Investigators used data from the Aspirin in Reducing Events in the Elderly trial and the follow-up observational study. Patients included had no major cognitive deficits, physical disability, or cardiovascular disease and lived in Australia or the United States. Nine cardiometabolic factors were regularly measured for up to 11 years between 2010 and 2022. Assessments were also performed for dementia diagnosis, and documents, such as medical reports, hospital records, and results from brain imaging and laboratory tests, were collected for the study.1
A total of 5390 individuals were included, with a mean age of 76.9 years, and 54.1% were women. Approximately 49.3% of patients had less than 12 years of education, and there were 1078 reported dementia cases. For those with dementia, the mean baseline was 77.1 years. Investigators reported that both the control group and those with dementia had declining BMI, but those with dementia had lower and steeper declines at least 11 years prior to dementia. Further, for waist circumference, those with dementia had lower values 10 years prior to diagnosis for all years from -10 years to 0 years.
The trajectories of diastolic blood pressure declines were similar, but there were lower levels of systolic blood pressure for those with dementia, although not significant. For blood glucose, levels increased substantially over time for both groups, but there were no differences between them. As for blood lipids, there was a steady increase of high-density lipoprotein for the controls. For those with dementia, there was a greater increase between -11 years and -4 years, but decelerated 4 years prior to dementia diagnosis. There were also higher levels 3 to 5 years prior to diagnosis but diminished after -5 years.
For low-density lipoprotein and total cholesterol, the investigators found a downward trend for both groups over 11 years, with no significant differences between either group. Lastly, triglycerides were consistently higher for those in the control group compared to those with dementia, but the difference was not significant.1
“These findings indicate that certain cardiometabolic factors may deviate from their usual levels before dementia,” the authors concluded. “These differences may be risk factors or early indicators associated with cognitive impairment, suggesting the importance of dynamic monitoring.”
READ MORE: Cardiology Resource Center
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