It has been becoming important to identify modifiable risk factors to prevent dementia. We investigated the association of individual and combined cardiovascular health (CVH) on dementia risk in older adults. From the National Health Insurance Service of Korea-Senior database, 191,013 participants aged ≥ 65 years without prior dementia or cerebrovascular diseases who had check-ups between 2004 and 2012 were assessed. Participants were stratified into three groups according to the number of optimal levels of CVH (low, 0–2; moderate, 3–4; and high CVH status, 5–6) and grouped by levels of individual CVH metrics, the number of optimal CVH metrics, and the CVH score. Over a median follow-up of 6.2 years, 34,872 participants were diagnosed with dementia. Compared with low CVH status, moderate and high CVH status were associated with a decreased risk of dementia (hazard ratio [95% confidence interval], 0.91 [0.89–0.92] for moderate; 0.78 [0.75–0.80] for high CVH status) including Alzheimer’s and vascular dementia. The risk of dementia decreased with an increase in the number of optimal CVH metrics (0.94 [0.93–0.94] per additional optimal metric) and with an increase in the CVH score (0.93 [0.93–0.94] per 1-point increase). After censoring for stroke, the association of CVH metrics with dementia risk was consistently observed. Among individual metrics, physical activity had the strongest association with the risk of dementia. In an older Asian population without prior dementia or cerebrovascular disease, a consistent relationship was observed between the improvement of a composite metric of CVH and the reduced risk of dementia.

确定可改变的风险因素以预防痴呆症变得越来越重要。我们调查了个体和综合心血管健康 (CVH) 与老年人痴呆症风险的关联。来自韩国国民健康保险服务数据库的 191,013 名年龄≥65 岁且既往未患痴呆症或脑血管疾病且在 2004 年至 2012 年期间接受过检查的参与者接受了评估。根据 CVH 最佳水平的数量（低，0-2；中等，3-4；高 CVH 状态，5-6）将参与者分为三组，并按单个 CVH 指标的水平分组，最佳的数量CVH 指标和 CVH 分数。在 6.2 年的中位随访期间，34,872 名参与者被诊断出患有痴呆症。与低CVH状态相比，中度和高度 CVH 状态与痴呆风险降低相关（风险比 [95% 置信区间]，中度为 0.91 [0.89–0.92]；高度 CVH 状态为 0.78 [0.75–0.80]），包括阿尔茨海默氏症和血管性痴呆。痴呆症的风险随着最佳 CVH 指标数量的增加（每增加一个最佳指标 0.94 [0.93–0.94]）和 CVH 评分的增加（每增加 1 点 0.93 [0.93–0.94]）而降低。在检查中风后，始终观察到 CVH 指标与痴呆风险的关联。在个人指标中，身体活动与痴呆症风险的关联最强。在没有既往痴呆症或脑血管疾病的老年亚洲人群中，观察到 CVH 综合指标的改善与痴呆症风险降低之间存在一致的关系。