Higher cardiovascular risk is tied to cognitive decline and neurodegeneration such as Alzheimer’s disease, a study spanning more than two decades has found.

Investigators followed 1,588 participants without dementia who had a mean age of 79 as part of the Rush Aging and Memory Project. Cardiovascular risk was assessed using the Framingham General Cardiovascular Risk Score, and participants underwent cognitive testing throughout the study period. Higher risk scores were associated with faster decline in global cognition, episodic memory, working memory, and perceptual speed during the follow-up period compared with the lowest score tertile, the researchers reported.

Cardiovascular risk was also linked to brain changes. When the researchers analyzed magnetic resonance imaging data from a subset of patients, higher scores were associated with smaller brain volumes in areas associated with cognitive decline and greater volume of white matter hyperintensities, a marker of neurodegeneration.

The editors of an accompanying editorial urged the medical community to proactively address heart health risks earlier in patients’ lives. “The results of this study suggest a useful tool for assessing dementia risk and support recommendations to aggressively manage cardiovascular risk factors in midlife,” they concluded.

The study was published in the Journal of the American College of Cardiology.