ArticleJournal of the American Heart Association2026
Long-Term Association of Cardiovascular Risk Burden With Dementia Risk: The Role of Life-Course Confounders in an Analysis of Cumulative and Specific Factors.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
backgroundPreventing dementia through risk factor modification is a global health priority. Although individual cardiovascular risk factors (CVRFs) have been linked to dementia, the cumulative burden of CVRFs, their changes over time, and the role of life-course confounders, especially early-life and psychological factors, remain poorly understood. This study aimed to estimate the longitudinal association between changes in CVRF burden and dementia risk under different hypothetical scenarios.
methodsWe analyzed 6051 participants from the ARIC (Atherosclerosis Risk in Communities) study, with a median follow-up of 21.9 years. We used the doubly robust g-formula method to estimate the 20-year risk difference for dementia under hypothetical strategies that maintain CVRF burden at different levels over time, explicitly accounting for competing mortality and time-varying confounding.
resultsAt baseline, 23.1% had ≥3 CVRFs. During follow-up, 1008 participants (17%) developed dementia. Low birth weight, midlife depression, and poor oral health emerged as important confounders. Maintaining a low CVRF burden was associated with a lower estimated risk of dementia compared with the natural course (risk difference, -4.31% [95% compatibility interval, -7.75% to -0.80%]), whereas maintaining a high CVRF burden was associated with a higher estimated risk (risk difference, 10.5% [95% compatibility interval, 5.8%-15.7%). Under model assumptions, 41.3% of dementia cases were estimated to be associated with the presence of CVRFs.
conclusionsHigher CVRF burden over time was associated with greater dementia risk. Findings suggest that early and sustained management of CVRFs, along with consideration of early-life and psychological factors, may play an important role in dementia prevention strategies.
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