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Cardiometabolic Multimorbidity Tied to Higher Risk for Dementia, Alzheimer Disease
Cardiometabolic multimorbidity has been linked to a more than doubled risk for vascular dementia and a 50% increased risk for Alzheimer disease, according to a new twin study utilizing a life-course approach by researchers at Karolinska Institutet. Findings were published in European Heart Journal.
“Both [cardiometabolic diseases] (CMDs) and dementia are complex disorders with multifactorial aetiologies involving environmental, lifestyle-related, and genetic factors,” wrote first author Abigail Dove, PhD student, Ageing Research Center, Department of Neurobiology, Care Sciences, and Society, at the Karolinska Institutet in Sweden. “Since CMDs and dementia are both partially heritable, it has been proposed that genetic factors may play a role in the CMD-dementia association. Twin data allowed us to address this question.”
Researchers used the Swedish Twin Registry to examine twins over the age of 60. More than 17,000 individuals were sorted according to whether they had 1 or more CMDs or none at all. All study participants were cognitively healthy at the beginning of the study. The authors monitored patients for up to 18 years to track who developed dementia and who did not.
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In addition to the increased risk for dementia and Alzheimer disease, the authors found that patients who developed CMDs at midlife rather than later were at the greatest risk of developing dementia. Additionally, for each CMD an individual had, the risk for dementia of all types increased by 42%, for Alzheimer disease increased by 26%, and for vascular dementia increased by 64%. “These findings underscore the need for special monitoring of individuals with cardiometabolic diseases to reduce their risk of developing dementia at an older age,” commented Dove.
Finally, researchers speculate that genetic background may underlie the “CMD-dementia association.” A closer examination of 400 specific pairs of “mismatched” twins—wherein the 2 twins in a pair exhibited difference in prevalence of CMD and possible development of dementia—showed that among dizygotic twin pairs, the twin with CMD was likely to be the one who developed dementia. However, in mismatched twins who were genetic replicas of each other, dementia risk was similar regardless of CMD status.
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