Diet, exercise, and smoking status are three of seven heart-healthy factors that may lower a person's risk of developing dementia—but few people score well on those metrics, according to a study published Tuesday in JAMA.
For the study, researchers observed 6,626 French residents who were at least 65 years old. The researchers rated each participant's cardiovascular health based on seven metrics referred to by the American Heart Association as Life's Simple 7:
- Blood pressure;
- Blood sugar;
- Smoking status; and
- Weight management.
For each metric, researchers scored participants' compliance as "poor" (zero points), "fair" (one point), or "optimal" (two points). For instance, to earn the full two points for weight management, a person had to have a body mass index below 25. To get two points for blood pressure, a person's blood pressure had to measure 120/80 mm Hg without medication.
After an average eight-year follow-up period, the researchers found 11.2% of participants had developed dementia. But, they found an association between the number of factors scored as optimal, and a lower risk of dementia. Among participants who had:
- Zero to two cardiovascular factors scored as optimal, 12.7% developed dementia;
- Three to four factors scored as optimal, 10.7% developed dementia; and
- At least five factors scored as optimal, just 7.9% developed dementia.
For each additional optimal metric, the researchers found the risk of dementia dropped by 10%.
When it came to tests related to cognition and memory, the researchers found people with zero metrics scored as optimal declined twice as fast as those with all seven metrics scored as optimal.
However, the researchers found optimal scores were uncommon—just 6.5% of the participants had optimal scores on at least five of the categories. Meanwhile, 36.4% had optimal scores in just one or two categories.
According to Cécilia Samieri, a professor of epidemiology at the University of Bordeaux and lead author on the study, the important takeaway of the research is that "combining optimal cardiovascular metrics can reduce your risk for dementia. You don't have to be perfect, but each time you add a factor you reduce your risk."
The authors acknowledged that getting people to adjust each of the seven cardiovascular factors from poor to optimal would be "challenging," but said getting them to go from poor to intermediate is much more feasible and still valuable.
Jeffrey Saver, a leader at the UCLA Stroke Center, and Mary Cushman, from the University of Vermont, in an accompanying editorial wrote, "To achieve a lifetime of robust brain health free of dementia, it is never too early or too late to strive for attainment of idea cardiovascular health. Given the aging population, this positive health message is important to communicate to all members of society" (Bakalar, New York Times, 8/21; Kaplan, Los Angeles Times, 8/21).
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