Dementia as a risk factor for coronary artery disease

Abstract

Western diet and lifestyle are known to predispose to low-grade chronic systemic inflammation, leading to dementia and coronary artery disease (CAD). It is hypothesized that dementia may also predispose individuals to CAD, just as it is well-established that CAD can predispose individuals to dementia. This study investigates the association between dementia and the risk of developing CAD. All participants (n = 2,002) were over 25 years old (986 females and 1,016 males), and all were residing in urban areas. Validated instruments, including a modified memory impairment scale, were used to assess dementia. The association between memory dysfunction and CAD was evaluated through regression analysis. Definite memory dysfunction was found in 4.54% of participants, with a higher prevalence in men than in women, and was more common than possible memory dysfunction. Regression analysis, after adjusting for age and body mass index, revealed that dementia scores were significantly associated with CAD risk (p<0.001) in both men (odds ratio [OR]: 0.90, 95% confidence interval [CI]: 0.82 - 0.98) and women (OR: 0.88, CI: 0.81 - 0.96). Similarly, diabetes mellitus scores were strongly associated with CAD risk (p<0.001) in men (OR: 0.76, CI: 0.68 - 0.87) and women (OR: 0.77, CI: 0.77 - 0.87). Sedentary behavior and tobacco use were also positively associated with CAD in both genders (p<0.05), whereas alcoholism showed a modest positive association with CAD risk in men but not in women. These findings suggest a potential association between dementia and CAD risk across genders. However, larger cohort studies are needed to confirm these results.

Keywords

Memory dysfunction / Memory impairment / Neuronal damage / Brain / Heart

Acknowledgments

None.

Funding

Sandoz Foundation of Gerontological Research, Australia (Grant No.: 2007-1).

Conflict of interest

Ram B. Singh is an Editorial Board Member of this journal but was not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.

Author contributions

Conceptualization: Ram B. Singh

Data curation: Ram B. Singh

Formal analysis: Ram B. Singh, M. A. Niaz

Investigation: Ram B. Singh, M. A. Niaz

Methodology: Ram B. Singh

Writing - original draft: Ram B. Singh, M. A. Niaz

Writing - review & editing: All authors

Ethics approval and consent to participate

All subjects gave informed consent for participation in the study. The study was approved by the ethics committee of the Halberg Hospital and Research Institute (Approval No: 2007 - 003).

Consent for publication

All the subjects gave informed written consent to publish their data.

Availability of data

Data used in this work is available from the corresponding author upon reasonable request.

References

[1] Biswas T, Townsend N, Gupta RD, et al. Clustering of metabolic and behavioural risk factors for cardiovascular diseases among the adult population in South and Southeast Asia: Findings from WHO STEPS data. Lancet Reg Health Southeast Asia. 2023; 12:100164. doi: 10.1016/j.lansea.2023.100164

[2] World Health Organization. Dementia; 2023. Last accessed on 2025 Jan 01].

[3] World Health Organization. Adopting a Healthy Lifestyle Helps Reduce the Risk of Dementia. Last accessed on 2025 Jan 01].

[4] Livingston G, Huntley J, Liu KY et al. Dementia prevention, intervention, and care: 2024 report of the lancet standing commission. Lancet. 2024; 404(10452):572-628. doi: 10.1016/S0140-6736(24)01296-0

[5] Singh RB, Watanabe S, Li D, et al. Diet and lifestyle guidelines and desirable levels of risk factors and protective factors for prevention of dementia: A scientific statement from joint symposium of JAAS and APCNS. Biomed Sci Tech Res. 2019; 17:12844-12864. doi: 10.26717/BJSTR.2019.17.003006

[6] Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018; 17:122. doi: 10.1186/s12933-018-0762-4

[7] Affuso F, Micillo F, Fazio S. Insulin resistance, a risk factor for Alzheimer’s disease: Pathological mechanisms and a new proposal for a preventive therapeutic approach. Biomedicines. 2024; 12(8):1888. doi: 10.3390/biomedicines12081888

[8] Butterfield DA, Halliwell B. Oxidative stress, dysfunctional glucose metabolism and Alzheimer disease. Nat Rev Neurosci. 2019; 20:148-160. doi: 10.1038/s41583-019-0132-6

[9] Singh RB, Wilkzynska A, Mojto V, et al. Development and validation of a questionnaire for assessment of memory impairment and dementia, by a new modified memory function rating scale. MOJ Public Health. 2022; 11(3):64-69. doi: 10.15406/mojph.2022.11.00377

[10] Singh RB, Wilczynska A, Fedacko J, et al. Prevalence of behavioral risk factors and their association with dementia in the urban population of North India. MOJ Public Health. 2023; 12(1):46-50. doi: 10.15406/mojph.2023.12.00409

[11] Singh RB, Wilczynska A, Agarwal A, et al. Association of Indo-Mediterranean neuroprotective diet (mind) pattern score, with depression, in an urban population of North India. The Indian mind study. Moj Public Health. 2024; 13:191-197. doi: 10.15406/mojph.2024.13.00460

[12] GBD 2016 Dementia Collaborators. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990-2016: A systematic analysis for the global burden of disease study 2016. Lancet Neurol2019; 18(1):88-106. doi: 10.1016/S1474-4422(18)30403-4

[13] Indian Council of Medical Research. Nutrient Composition of Indian Foods. Hyderabad, India: ICMR; 2003.

[14] Guo X, Ma L. Inflammation in coronary artery disease-clinical implications of novel HDL-cholesterol-related inflammatory parameters as predictors. Coron Artery Dis. 2023; 34(1):66-77. doi: 10.1097/MCA.0000000000001198

[15] Yoon JH, Hwang J, Son SU, et al. How can insulin resistance cause Alzheimer’s disease? Int J Mol Sci. 2023; 24(4):3506. doi: 10.3390/ijms24043506

[16] Fang YC, Hsieh YC, Hu CJ, Tu YK.Endothelial dysfunction in neurodegenerative diseases. Int J Mol Sci. 2023; 24(3):2909. doi: 10.3390/ijms24032909

[17] De La Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol. 2008; 2:1101-1113. doi: 10.1177/193229680800200619

[18] Ahmed S, Mahmood Z, Zahid S. Linking insulin with Alzheimer’s disease: Emergence as type III diabetes. Neurol Sci. 2015; 36(10):1763-1769. doi: 10.1007/s10072-015-2352-5

[19] Song J, Lee WT, Park KA, Lee JE. Association between risk factors for vascular dementia and adiponectin. Biomed Res Int. 2014; 2014:261672. doi: 10.1155/2014/261672

[20] Olesen KKW, Thrane PG, Gyldenkerne C, et al. Diabetes and coronary artery disease as risk factors for dementia. Eur J Prev Cardiol. 2025; 32:477-484. doi: 10.1093/eurjpc/zwae153

[21] How Alzheimer’s Disease can Affect Heart Health. Last accessed on 2025 Jan 05].

[22] Tini G, Scagliola R, Monacelli F, et al. Alzheimer’s disease and cardiovascular disease: A particular association. Cardiol Res Pract. 2020; 2020:2617970. doi: 10.1155/2020/2617970

[23] Ofori-Asenso R, Chin KL, Curtis AJ, Zomer E, Zoungas S, Liew D. Recent patterns of multimorbidity among older adults in high-income countries. Popul Health Manag. 2019; 22(2):127-137. doi: 10.1089/pop.2018.0069

[24] Deckers S, Shievink SH, Rodriquez MM, et al. Coronary heart disease and risk for cognitive impairment or dementia: Systematic review and meta-analysis. PLoS One. 2017; 12(9):e0184244. doi: 10.1371/journal.pone.0184244

[25] Santos CY, Snyder PJ, Wu WC, Zhang M, Echeverría A, Cerón C. Pathophysiologic relationship between Alzheimer’s disease, cerebrovascular disease, and cardiovascular risk: A review and synthesis. Alzheimers Dement (Amst). 2017; 7:69-87. doi: 10.1016/j.dadm.2017.01.005

[26] Dementia and Ischemic Heart Disease Co-Morbidity among Canadians above 65 Years and Older. Available from: https:// www.canada.ca/en/public/health/services/publications/ diseases/conditions/dementia-ischemic-heart-disease-comorbidity.html [Last accessed on Jan 07, 2025 ].

[27] Iadecola C. The pathobiology of vascular dementia. Neuron. 2013; 80(4):844-866. doi: 10.1016/j.neuron.2013.10.008

[28] Subramanian K, Gianni D, Balla C, et al. Cofilin-2 phosphorylation and sequestration in myocardial aggregates: Novel pathogenetic mechanisms for idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 2015; 65(12):1199-1214. doi: 10.1016/j.jacc.2015.01.031

[29] Liu YH, Gao X, Na M, Kris-Etherton PM, Mitchell DC, Jensen GL. Dietary pattern, diet quality, and dementia: A systematic review and meta-analysis of prospective cohort studies. J Alzheimers Dis. 2020; 78:151-168. doi: 10.3233/JAD-200499

[30] Nucci D, Sommariva A, Degoni LM, et al. Association between Mediterranean diet and dementia and Alzheimer disease: A systematic review with meta-analysis. Aging Clin Exp Res. 2024; 36(1):77. doi: 10.1007/s40520-024-02718-6

[31] Singh RB, Verma NS, Maheswari A, et al. Can dementia predispose cardiovascular diseases and diabetes? World heart J. 2019; 11:85-89.