Nearly a decade ago the American Heart Association began to promote seven targets to shoot for to achieve ideal cardiovascular health.
They hoped the strategy, called “Life’s Simple 7,” would reduce the incidence of heart disease, stroke and diabetes. This could be achieved, they said, with simple lifestyle changes plus medication if needed.
What’s good for the heart is known to be good for the brain. So, could the same strategy prevent dementia? Read on to find out…
The Seven Factors
According to the “Life’s Simple 7” strategy, you can lower your cardiovascular risk by achieving three biological metrics:
- blood pressure below 120/80
- total cholesterol less than 200
- fasting blood glucose below 100
Plus, four behavioral metrics:
- a body mass index of less than 25
- not smoking
- 150 minutes of moderate aerobic activity a week and muscle strengthening exercise on two days a week.
- more fruit and vegetable consumption, enjoying fewer sugary drinks, sweets, processed foods, partially hydrogenated oils and excessive calories
Heart Health Predicts Your Risk of Dementia
To test whether this cardiovascular strategy is also effective in safeguarding against dementia, scientists conducted two trials and published their results in the journal JAMA in 2018. Both confirmed a direct link between heart health and memory health.
The first study included mature adults. It showed those meeting more of “Life’s Simple 7” targets experienced slower cognitive decline and a reduced risk of dementia.
The second study examined younger adults. Here, failure to adhere to good cardiovascular practices led to decreased blood flow to the brain and more white matter lesions, increasing the risk of dementia in later life.
“It’s Never Too Late or Too Early” to Improve Heart Health for Better Memory
An editorial in the same journal commented on both studies saying:
“Available evidence indicates that to achieve a lifetime of robust brain health free of dementia, it is never too early or too late to strive for attainment of ideal cardiovascular health.”
The JAMA trials are unique because most studies assess the risk factors for dementia later in life, when the disease process starts 15 to 20 years before symptoms begin.
Once symptoms begin, it’s oftentimes too late to halt the progress of the disease even if the patient starts following healthy heart guidelines.
To address this issue, researchers from across Europe took the long preclinical phase of dementia into account by analyzing health data from 7,899 British civil servants starting at age 50 and then following them over the next 25 years. A subgroup of 771 also received brain scans.
The researchers divided people into three groups, scoring them based on how well they adhered to the “Life’s Simple 7” guidelines: Poor (scores 0-6), intermediate (scores 7-11) and optimal (scores 12-14).
Dementia Risk Reduced by 60 Percent
After taking into account a wide range of socio-demographic factors that could influence the results, researchers found those with higher cardiovascular health scores enjoyed a dramatically lower risk of dementia.
Participants with poor scores had nearly triple the chance of dementia, with a dementia rate of 3.2 for every 1000 persons. The intermediate group had an incidence of 1.8 for every 1000 persons. For those in the optimal group, the dementia rate dropped to 1.3 for every 1000 persons, a 60 percent lower risk of dementia compared to the poor scoring category.
What’s more, each additional increase in cardiovascular health score up to 14 saw a similar, dramatic reduction in the risk of dementia. This suggests, the researchers wrote, “that even small improvements in cardiovascular risk factors are likely to be beneficial for cognitive health.”
The brain scan results confirmed these findings. They showed a better “Life’s Simple 7” score at age 50 was linked to greater whole brain and gray matter volume at age 70.
Warning: Poor Heart Health Doesn’t Always Receive a Diagnosis
The lead author, Professor Archana Singh-Manoux, commented on one surprise finding from the study. The link between a low score and higher dementia risk was evident even for those who weren’t diagnosed with cardiovascular disease. This means, for example, that someone might have had high cholesterol or an unhealthy BMI but still did not have detectable heart disease.
“What this suggests,” she said, “is that the association between cardiovascular health and dementia is not simply because of stroke or coronary heart disease.”
She also added that while the evidence presented was “robust,” a more detailed and specific prevention tool than the one devised for cardiovascular health is needed to prevent dementia.
“It’s not easy. If you look at prevention guidelines for dementia there’s 50 risk factors in there. How many of them are causal? We need to figure that out first.”
The study did not address whether the people with low blood sugar, cholesterol and blood pressure numbers had come by them naturally or had achieved them by means of medication.
Readers of this newsletter know I’m not a big fan of pharmaceuticals. To the extent that you can optimize “Life’s Simple 7” by making good lifestyle choices, it seems to me they are far more likely to protect you from dementia – and other diseases, too.