Middle-aged adults with signs of heart damage may be at increased risk of cognitive decline and dementia decades later, according to new research from University College London (UCL).
The study, published in the European Heart Journal and funded by the British Heart Foundation, found elevated levels of cardiac troponin I – a protein released when heart muscle is damaged – were linked to a higher likelihood of developing dementia over a 25-year period.
The research suggests that even moderately raised troponin levels, which may not cause any symptoms, could indicate ongoing heart damage that affects blood vessels and reduces blood flow to the brain. Elevated levels were detected up to 25 years before participants were diagnosed with dementia, highlighting a potential early warning sign.
‘Poor heart health in middle age puts people at increased risk of dementia in later life. Damage to the brain seen in people with dementia accumulates slowly over the decades before symptoms develop,’ Professor Eric Brunner of UCL’s Institute of Epidemiology and Health Care, said. ‘Control of risk factors common to both heart disease, stroke and dementia in middle age, such as high blood pressure, may slow or even stop development of dementia as well as cardiovascular disease.
‘We now need to carry out studies to investigate how well troponin levels in the blood can predict future dementia risk. Our early results suggest that troponin could become an important component of a risk score to predict future probability of dementia.’
The study followed nearly 6,000 participants in the Whitehall II study, which began in 1985. Participants aged 45 to 69 had troponin levels measured and were monitored for an average of 25 years, during which 695 developed dementia.
Those with higher troponin levels experienced faster declines in memory and reasoning. MRI scans of a subset showed smaller hippocampal and grey matter volumes, equivalent to brains roughly three years older.
Lead author Dr Simon Chen (UCL Psychiatry) said: ‘Our study represents the longest follow-up to date to investigate links between raised cardiac troponin levels, and cognitive decline and dementia.
‘We also found that higher blood troponin levels in people with dementia compared with controls were more marked in midlife compared to late life, suggesting that midlife blood troponin levels may be a better biomarker for dementia risk prediction.’
Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, added: ‘This study is an important reminder that our heart and brain health are inseparable. The results suggest that middle age is a particularly sensitive time, with damage at this stage setting up a trajectory of decline in heart and brain health.’
Photo: Jesse Orrico/UnSplash
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