Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank

Abstract Background Cardiometabolic diseases (CMDs) including type 2 diabetes, heart disease, and stroke, increase the risk of dementia. However, the correlation between CMDs and dementia in different subgroups and the underlying pathophysiological mechanisms linking CMDs with dementia warrant furth...

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Main Authors: Junrun Zhang, Xiaxuan Huang, Yitong Ling, Xiaomei Xie, Xiuli Zeng, Jun Lyu, Li’an Huang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23352-5
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author Junrun Zhang
Xiaxuan Huang
Yitong Ling
Xiaomei Xie
Xiuli Zeng
Jun Lyu
Li’an Huang
author_facet Junrun Zhang
Xiaxuan Huang
Yitong Ling
Xiaomei Xie
Xiuli Zeng
Jun Lyu
Li’an Huang
author_sort Junrun Zhang
collection DOAJ
description Abstract Background Cardiometabolic diseases (CMDs) including type 2 diabetes, heart disease, and stroke, increase the risk of dementia. However, the correlation between CMDs and dementia in different subgroups and the underlying pathophysiological mechanisms linking CMDs with dementia warrant further investigation. Methods This prospective cohort study included a total of 287,748 individuals from the UK Biobank. The outcome measures included all-cause dementia (ACD), Alzheimer’s disease (AD) and vascular dementia (VD). Cox regression models and subgroup analyses were used to assess the association between CMD status and dementia, while mediation analysis was evaluated potential roles of inflammatory/metabolic markers in the observed associations. Results Compared with those without CMD, those with CMD multimorbidity had an elevated risk of ACD (hazard ratio [HR]: 2.27, 95% confidence interval [95% CI]: 1.95–2.63), AD (HR: 1.49, 95% CI: 1.13–1.97), and VD (HR: 3.70, 95% CI: 2.93–4.69). According to the subgroup analyses, the positive correlations between CMDs and ACD, as well as AD, were stronger in individuals who were under the age of 60 or female. Mediation analysis indicated that neutrophils mediated 2.43% of the association of CMDs with ACD, while glucose and hemoglobin A1c mediated 9.22% and 11.85% of the association of CMDs with ACD, respectively. Conclusion This study further expands the research on cardiometabolic multimorbidity and dementia, highlighting the need for focused attention on specific populations, such as younger individuals and women. Additionally, inflammatory and metabolic biomarkers, as potential mediators, provide critical insights into the complex pathophysiological mechanisms.
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spelling doaj-art-facc1b5e07b445d28d2e9b4e77bd57f32025-08-20T04:03:11ZengBMCBMC Public Health1471-24582025-07-0125111310.1186/s12889-025-23352-5Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobankJunrun Zhang0Xiaxuan Huang1Yitong Ling2Xiaomei Xie3Xiuli Zeng4Jun Lyu5Li’an Huang6Department of Neurology, The First Affiliated Hospital of Jinan UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Jinan UniversityDepartment of Neurology, The First Affiliated Hospital of Jinan UniversityDepartment of Neurology, The First Affiliated Hospital of Jinan UniversityDepartment of Neurology, The First Affiliated Hospital of Jinan UniversityDepartment of Clinical Research, The First Affiliated Hospital of Jinan UniversityDepartment of Neurology, The First Affiliated Hospital of Jinan UniversityAbstract Background Cardiometabolic diseases (CMDs) including type 2 diabetes, heart disease, and stroke, increase the risk of dementia. However, the correlation between CMDs and dementia in different subgroups and the underlying pathophysiological mechanisms linking CMDs with dementia warrant further investigation. Methods This prospective cohort study included a total of 287,748 individuals from the UK Biobank. The outcome measures included all-cause dementia (ACD), Alzheimer’s disease (AD) and vascular dementia (VD). Cox regression models and subgroup analyses were used to assess the association between CMD status and dementia, while mediation analysis was evaluated potential roles of inflammatory/metabolic markers in the observed associations. Results Compared with those without CMD, those with CMD multimorbidity had an elevated risk of ACD (hazard ratio [HR]: 2.27, 95% confidence interval [95% CI]: 1.95–2.63), AD (HR: 1.49, 95% CI: 1.13–1.97), and VD (HR: 3.70, 95% CI: 2.93–4.69). According to the subgroup analyses, the positive correlations between CMDs and ACD, as well as AD, were stronger in individuals who were under the age of 60 or female. Mediation analysis indicated that neutrophils mediated 2.43% of the association of CMDs with ACD, while glucose and hemoglobin A1c mediated 9.22% and 11.85% of the association of CMDs with ACD, respectively. Conclusion This study further expands the research on cardiometabolic multimorbidity and dementia, highlighting the need for focused attention on specific populations, such as younger individuals and women. Additionally, inflammatory and metabolic biomarkers, as potential mediators, provide critical insights into the complex pathophysiological mechanisms.https://doi.org/10.1186/s12889-025-23352-5Cardiometabolic diseaseDementiaInflammationMetabolism
spellingShingle Junrun Zhang
Xiaxuan Huang
Yitong Ling
Xiaomei Xie
Xiuli Zeng
Jun Lyu
Li’an Huang
Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank
BMC Public Health
Cardiometabolic disease
Dementia
Inflammation
Metabolism
title Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank
title_full Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank
title_fullStr Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank
title_full_unstemmed Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank
title_short Associations of cardiometabolic multimorbidity with all-cause dementia, alzheimer’s disease, and vascular dementia: a cohort study in the UK biobank
title_sort associations of cardiometabolic multimorbidity with all cause dementia alzheimer s disease and vascular dementia a cohort study in the uk biobank
topic Cardiometabolic disease
Dementia
Inflammation
Metabolism
url https://doi.org/10.1186/s12889-025-23352-5
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