Abstract 31: Cardiovascular Health at Young and Middle Ages and Dementia in Older Age - The Chicago Heart Association Detection Project in Industry Study

Background: Data are sparse regarding the association of cardiovascular health (CVH) in younger/middle age with the diagnosis of dementia later in life. Methods: We used linked data from the Chicago Heart Association Detection Project in Industry Study assessed in 1967-73 with fee-for-service Medicare claims and National Death Index data from 1991-2010. Participants were ≤65 years old in 1991 and Medicare eligible during 1991-2010. Baseline CVD risk factors included blood pressure, cholesterol, BMI, smoking, and diabetes. Participants were classified into four strata: favorable levels of all factors, 0 factors high but 1+ elevated, 1 high, and ≥2 high risk factors. ICD-9 codes were used to identify date of first dementia diagnosis. We used competing Cox models to estimate hazards for dementia in Medicare data after age 65 with competing event of all-cause mortality prior to dementia diagnosis. Covariates included baseline age, race, sex, and education attainment. Results: This study included 4,273 females and 8,381 males, 10.3% Black, baseline ages 18-48. Dementia was diagnosed in 5.1% of study participants. The prevalence of dementia diagnosis increased with increasing CVH burden from 3.4% to 6.4%. During 1991-2010 in Medicare, the average time from age 65 to the first dementia diagnosis was 7.7 years. Greater CVH in younger age was associated with a reduced risk of being diagnosed with dementia in later life. Hazards ratios of experiencing dementia in those with baseline favorable levels, 0 RF high, and 1 only high RF were lower by 36%, 29%, and 28% respectively as compared to those with 2+ high-risk factors (see Table - Model 1). Similar trends were observed when deaths were treated as competing events although the association was attenuated (Model 2). Patterns were similar when stratified by sex or race. Conclusions: Having a favorable CVH profile at younger age is associated with lower risk of dementia in older age. Improvements in CVH in younger age may translate to increased independence and quality of life later in life.