Abstract
There is growing evidence that midlife risk factors for vascular disease also are
risk factors for dementia, but there is still need for long-term observational studies
to address this. Our objective was to investigate the association of midlife vascular
disease risk factors with dementia death. Participants were included in The Norwegian
Counties Study (NCS) in the period 1974–78, aged 35–50 years at baseline. Information from NCS was linked with the Cause of Death Registry
through the year 2009 using the unique personal identification number. The study included
48,793 participants, 1.5 million person years and 486 dementia deaths (187 Alzheimer's; 299 non-Alzheimer's
dementia). Cox regression for cause-specific hazards was used. Dementia death was
associated with increased total cholesterol levels (>7.80 vs. <5.20 mmol/l: HR=2.01, 95% confidence interval 1.37–2.93); diabetes (HR=2.43, 95% CI 1.40–4.32) and low body mass index (<20 kg/m2 vs. 20–25 kg/m2: HR=1.76, 95% CI 1.15–2.68) in midlife. The associations remained after adjustment for
other vascular risk factors and educational level. Smoking status or blood pressure
in midlife was not significantly associated with risk of dementia death, although
the results indicate a possible increased risk in heavy smokers. People suffering
from high cholesterol levels, diabetes or underweight in midlife are at increased
risk of dying from or with dementia later in life. Our findings add to previous results
suggesting that intervention in midlife may be important. To better understand the
mechanisms involved in the associations between midlife underweight, diabetes, and
elevated cholesterol level and late-life dementia death, these links need to be further
investigated.
Keywords
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Article info
Publication history
Published online: November 12, 2012
Accepted:
October 22,
2012
Received in revised form:
October 18,
2012
Received:
July 13,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
