Cardiac, stroke risk assessments trump dementia scoring as cognitive decline predictors

An evaluation of cardiovascular and stroke risk was found to be a more promising predictor of potential cognitive decline than an assessment used to predict development of dementia, according to a study in the April issue of Neurology.

Three risk assessments were compared to see which most accurately predicted eventual cognitive decline in late middle age. The risk scores compared in this study, designed by Sara Kaffashian, PhD, from the French National Institute of Health and Medical Research, in Paris, and colleagues, were the Cardiovascular Risk Factors, Aging and Dementia risk score, the Framingham general cardiovascular disease risk score and the Framingham stroke risk score. Results of the study showed all three were able to predict cognitive losses except for tests for memory, but the Framingham cardiovascular and stroke risk scores were more precisely predictive of eventual cognitive decline and could potentially be more valuable for its focus on variable risk factors like smoking.

“This is the first study that compares these risk scores with a dementia risk score to study decline in cognitive abilities 10 years later,” said Kaffashian, in a press release.

The dementia risk score included some cardiovascular inquiry, including total cholesterol and blood pressure, as well as age, education, exercise and body mass index (BMI), and genetic information relating to the APOE e4 genotype. The heart disease risk score included many of the same inquiries with the addition of smoking habits, treatment for high cholesterol and cardiac event history and presence of conditions such as heart attack and cardiac arrythmia.

“Although the dementia and cardiovascular risk scores all predict cognitive decline starting in late middle age, cardiovascular risk scores may have an advantage over the dementia risk score for use in prevention and for targeting changeable risk factors since they are already used by many physicians,” added Kaffashian. “The findings also emphasize the importance of risk factors for cardiovascular disease such as high cholesterol and high blood pressure in not only increasing risk of heart disease and stroke but also having a negative impact on cognitive abilities.”

Data from a registry of 6,895 and 3,413 women with a mean age of over 55 years were used for this retrospective study spanning 10 years of research. Risk scoring was based on information provided by subjects in the form of a questionnaire. Clinical examinations were held three times during the decade of study.