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 Researchers examined data on 9,772 adults, ages 44 to 79, who all
had at least one MRI brain scan and provided general health
information and medical records for the analysis.
The researchers looked for associations between brain structure and
so-called vascular risk factors. They found that except for high
cholesterol, all of the other vascular risk factors - smoking, high
blood pressure, high pulse pressure, diabetes, and obesity - were
linked to abnormal brain changes seen in dementia.
And the more vascular risk factors a person had, the poorer was
their brain health, as evidenced by greater brain shrinkage, less
gray matter (tissue mainly on the surface of the brain) and less
healthy white matter (tissue in deeper parts of the brain).
"There are some things that contribute to cognitive and brain aging
that we cannot change (like our genes), so you could look at this
like a list of things that we can have some agency over - so-called
'malleable' risk factors," said lead study author Simon Cox of the
University of Edinburgh in the U.K.
"There are so many other benefits to improving your cardiovascular
health (improving diet, weight, exercise, blood sugar control) and
stopping smoking, but in combination with other good evidence out
there, maintaining brain health is probably another one," Cox said
by email.
The strongest links between the vascular risk factors and brain
structure were in areas of the brain known to be responsible for our
more complex thinking skills, and which deteriorate during the
development of Alzheimer's disease and dementia.
Risk factors for heart disease appeared to impact brain health just
as much in middle age as they did later in life, researchers report
in the European Heart Journal.
And the risk of structural changes in the brain associated with
cognitive decline also increased with each additional vascular risk
factor, even in adults who appeared otherwise healthy, the study
found.
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Smoking, high blood pressure and diabetes were the three vascular
risk factors that showed the most consistent associations across all
types of brain tissue. High cholesterol levels were not associated
with any differences in the MRI scans.
The study wasn't a controlled experiment designed to prove whether
or how specific risk factors might directly cause dementia or
cognitive decline.
"The precise mechanisms underlying these findings are not entirely
clear," said Dr. Jeffrey Burns, co-director of the University of
Kansas Alzheimer's Disease Center.
"The findings do underscore our increasing recognition that dementia
is a complex syndrome and that vascular factors contribute to brain
changes that we see and expect in people who are diagnosed with
Alzheimer's disease," Burns, who wasn't involved in the study, said
by email.
Still, there's enough evidence of the connection for patients to do
what they can to promote brain health as they age, said Dr. Andrew
Budson of the Veterans Affairs Boston Healthcare and Boston
University School of Medicine.
"Because smoking, hypertension, and diabetes were the strongest risk
factors, if you have a number of risk factors, these are the most
important ones to work on," Budson, who wasn't involved in the
study, said by email.
"Quit smoking cigarettes today," Budson advised. "Control high blood
pressure and diabetes through medications, aerobic exercise, and
weight loss. These measures can reduce the daily brain damage that
will otherwise occur."
SOURCE: http://bit.ly/2WD9cw9 European Heart Journal, online March
11, 2019.
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