Race, prehypertension among midlife risk factors for dementia

Potentially modifiable midlife vascular risk factors could be associated with dementia later in life, according to a study published online Aug. 7 in JAMA Neurology.

A research team, led by Rebecca F. Gottesman, MD, PhD, a neurologist at Johns Hopkins Bayview Medical Center in Baltimore, examined 25-year incidence of dementia in the Atherosclerosis Risk in Communities Study conducted from 1987-89 through 2011-13. The study included 15,744 participants across four communities who were aged 44 to 66 at baseline. These participants were analyzed during an initial visit and through four additional in-person visits.

In total, 1,516 cases of dementia were found among the group, with the following traits associated with increased risk: black race, older age, lower educational attainment, APOE e4 genotype, midlife smoking, diabetes, prehypertension and hypertension.

“Vascular risk factors are modifiable, and their association with dementia emphasizes that many cases of dementia may be prevented or delayed,” Gottesman and colleagues wrote. “Future studies need to evaluate the mechanism of this racial disparity in dementia rates and assess subclinical vascular disease (systemic and cerebrovascular) as a risk factor for dementia.”