How protecting your heart health may prevent dementia; lifestyle factors key to avoiding cardiovascular disease, study says
- About 30 to 40 per cent of dementia cases are related to factors that also increase an individual’s chances of developing cardiovascular disease, research finds
- Harvard’s Dr Albert Hofman wants people to know dementia is not ‘an inevitable disease of the elderly’ and we must make behaviour changes to avoid it
What is good for your heart is good for your brain.
This is the message many doctors share. They include Dr Albert Hofman, chair of the department of epidemiology at the Harvard T.H. Chan School of Public Health at Harvard University, in the US state of Massachusetts.
“Without a circulation, there is no brain function,” he says simply, though the relationship is more complex.
Hofman and his team have revealed welcome and encouraging news about dementia. They tracked the health of nearly 50,000 adults in North America and Europe over the age of 65 to understand how the rate of dementia had changed over a quarter of a century.
They discovered the rate has declined by 13 per cent per decade over the past 25 years. Hofman attributes this to better heart health – and better awareness of the need to safeguard it.
About 30 to 40 per cent of all dementia cases are related to factors that also increase an individual’s chances of developing cardiovascular disease, Hofman says.
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Improved heart health is evidenced in the staggering drop in fatal heart attacks: research by Rutgers University, in the US state of New Jersey, found that deaths from coronary heart disease among people aged 25 to 84 in the US dropped more than 40 per cent in less than 40 years, from 397,623 in 1990 to 236,953 in 2019.
The fact that global smoking rates are also down since 1990 – a 27 per cent fall for men and 38 per cent for women – is no coincidence, especially in the US, which was the first country to introduce public health campaigns to alert people to tobacco’s dangers.
An oncologist who specialises in lung cancer told me we are seeing the positive impact of warnings on cigarette packets and smoking bans now, a generation or two after those campaigns took off.
The results of a recent study by the Chinese Academy of Medical Sciences and Peking Union Medical College, published in JAHA, the Journal of the American Heart Association, show the ill effects on the brain of coronary heart disease.
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It is not only the direct effects of cardiovascular diseases that negatively affect the brain – my mother’s stroke caused damage to her brain so she could no longer read – it is also the indirect effects of the inflammatory processes that come with heart disease.
Recognising public health problems, such as smoking, and tackling them through meaningful policy changes have the greatest impact, Hofman says.
Sea change is what we need given we’re faced with what has been dubbed a “silver tsunami” of dementia patients.
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Hofman points to the “enormous success in the last part of the last century and the early part of this one in preventing heart attack and stroke” – and says we could have the same success in preventing dementia.
We might not eradicate dementia, he says. But if we could push its onset back, people could have more years of quality living and may die, “for want of a better phrase, a better death”.
While there are medications in the pipeline that will help to eradicate the direct risk of the plaques and tangles associated with dementias, Hofman says treatment is not the solution.
“Prevention is. I am hopeful, but we need to defeat the public’s fatalistic attitude. Dementia is not an inevitable part of ageing.”
If cardio health is generally improving, what of the risks to the brain from rising rates of obesity and Type 2 diabetes?
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Your quality of life is much better, irrespective of age, when you have good health, Hofman reminds me, so it is imperative to understand the value of prevention. It is not just better than cure. It may be all we have in the case of dementia – for which there is no cure.
