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Vascular health a significant factor in the development of dementia – NUI Galway study

Controlling high blood pressure, diabetes, and following a healthier lifestyle from an earlier age could reduce risk of dementia in older age, researchers say

Vascular risk factors have a significant impact on a person’s chances of developing dementia, according to new research led by NUI Galway.

In collaboration with researchers from Boston University, and the University of Texas Health Sciences Centre in San Antonio, the NUI Galway team looked at potential predictors for decline in cognitive function by analysing data from 5,000 people who took part in the US-based Framingham Heart Study.

The research analysed the most important risk factors for dementia according to age. High blood pressure, cardiovascular disease, stroke, and diabetes all increase the risk of a patient experience cognitive decline.

“What we’re seeing is that assessing a person’s risk for developing dementia needs to be individualised – taking into account their age, sex, vascular risk factors, rather than a one size fits all approach” explains Professor Emer McGrath, Associate Professor at the College of Medicine Nursing and Health Sciences at NUI Galway and Consultant Neurologist at Saolta University Hospitals, who led the study.

“Take for example diabetes. People who have a history of diabetes, by their mid-50s, have four times the risk of developing dementia from 65 onwards, compared with people with no history of diabetes,” she said, speaking to IMT.

The most important vascular risk factors for dementia at age 55 were high blood pressure and diabetes mellitus; at age 65, cardiovascular disease (e.g. heart attacks or angina); at ages 70 and 75, diabetes mellitus and previous stroke; at age 80, diabetes mellitus, previous stroke and not taking blood-pressure lowering medication.

The study was published in Neurology®, the medical journal of the American Academy of Neurology.

Professor Sudha Seshadri, co-author of the study, is Professor of Neurology and Director of the Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases at the University of Texas Health Sciences Center, San Antonio and Senior Investigator with the Framingham Heart Study.

At younger ages, vascular risk factors like blood pressure seemed more important. At older ages, the effects of long-standing exposure to risk factors in the form of organ damage, such as stroke, seemed to best predict risk of dementia.

Prof. McGrath says that the considering cardiovascular risks is important when thinking about population level interventions and public health approaches for dealing with dementia.

“The key message we have, similar to heart disease, is to reduce your blood pressure: take pressure medication, lower your salt intake, live an active lifestyle and eat healthy,” she says.

All these things will reduce a person’s risk of developing dementia – a condition that impacts approximately 64,000 people in Ireland, according to the Alzheimer Society of Ireland.

It is estimated that the number of people with the condition will more than double in the next 25 years to more than 150,000 by 2045.

Further research conducted in Ireland has also revealed potential biomarkers for Alzheimer’s Disease, meaning that patients may be able to receive treatment before developing symptoms – Prof. Emer McGrath sat down to discuss it with editor Terence Cosgrave in this month’s print edition of Irish Medical Times

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