Cardiometabolic diseases may serve as clinical markers for early-onset dementia

Hypertension and diabetes in midlife have been associated with increased risk of early-onset dementia, specifically the non-Alzheimer’s type, in a population-based case-control study.

The study included 334 individuals with early-onset dementia (median age 60 years, 47 percent male) and 1,991 individuals without the condition, matched according to sex, year of birth, and calendar year.

Researchers obtained data on cardiometabolic disease history before the onset of dementia from hospitalization records and drug prescriptions. Associations between cardiometabolic diseases and early-onset dementia were analysed using conditional logistic regression.

Compared with the control group, the early-onset dementia group had higher rates of hospitalization for hypertension (14.97 percent vs 8.74 percent) and diabetes (6.59 percent vs 3.16 percent). History of cardiometabolic disease and their corresponding drug prescriptions were associated with increased odds of early-onset dementia.

The most pronounced odds estimates were observed for diabetes (OR, 2.22, 95 percent confidence interval [CI], 1.33–3.69) and hypertension (OR, 1.85, 95 percent CI, 1.32–2.61), antidiabetic drugs (OR, 1.49, 95 percent CI, 1.01–2.19), lipid-lowering agents (OR, 1.36, 95 percent CI, 1.03–1.79), and antihypertensive drugs (OR, 1.47, 95 percent CI, 0.93–2.32).

In subgroup analyses, the highest ORs for early-onset dementia were observed for glucose-lowering medications (OR, 1.78, 95 percent CI, 1.08–2.93) and antithrombotics (OR, 1.57, 95 percent CI, 1.06–2.33) among men and blood pressure-lowering medications (OR, 1.92, 95 percent CI, 0.96–3.85) and lipid-modifying agents (OR, 1.40, 95 percent CI, 0.95–2.08) among women. Among individuals aged <55 years, strong associations were observed for most antihypertensive classes.

Use of drugs acting on metabolic and cardiovascular systems showed a clear association with non-Alzheimer’s early-onset dementia. This was true for antiarrhythmics (OR, 2.50, 95 percent CI, 0.94–6.64), diabetes medications (OR, 2.24, 95 percent CI, 1.40–3.60), and calcium antagonists (OR, 1.51, 95 percent CI, 1.01–2.25).