Cardiovascular health and its association with dementia, Parkinson's Disease, and mortality among UK older adults

Background

Previous research has primarily examined individual factors of cardiovascular health (CVH) and disease in PD and dementia, but no study has examined CVH measures with PD, dementia, and mortality simultaneously while accounting for potentially confounding factors.

Objectives

To examine the relationship between CVH, all-cause dementia, Parkinson's disease (PD), and mortality, focusing on associations and health transitions from a large population-based study.

Methods

We investigated these relationships using Cox Proportional Hazards and multistate parametric models with Weibull regression from the UK Biobank data (n = 269,816, Age = 50 + y individuals, ≤15y follow-up, 2006–2021).

Results

Full Cox models found poor CVH (measured with standardized reverse-coded Life's Essential 8 total score, LE8_zrev), to be associated with increased risks for all-cause dementia (Hazard Ratio (HR) = 1.14, 95 % CI: 1.11–1.18, P < 0.001) and all-cause mortality (HR = 1.31, 95 % CI: 1.29–1.33, P < 0.001). Unlike “Healthy to PD” and “Dementia→Death” transitions, PD→Death (Weibull full model: HR = 1.18, 95 % CI: 1.06–1.31, P = 0.002), Healthy→dementia (HR = 1.15, 95 % CI: 1.12–1.19, P < 0.001), and Healthy→Death (HR = 1.33, 95 % CI: 1.32–1.35, P < 0.001) exhibited a positive relationship with poor CVH.

Conclusions

Poor CVH is directly associated with an increased risk of mortality from PD, transition into Dementia, and all-cause mortality without dementia or PD occurrence. Clinicians should aggressively screen for and manage CVH risk measures to reduce the risk of poor cognitive health outcomes.