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Cardiovascular Disease Risk Burden, Cognitive Impairments and Incident Dementia among Community-Dwelling Middle-Aged and Older Adults: An 8-Year Longitudinal Follow-up Study

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To evaluate the associations between cardiovascular disease (CVD) risk burden (estimated by the World Health Organization (WHO) algorithm) and cognitive impairments (e.g., incident dementia, global and domain-specific impairments) among CVD-, dementia- and disability-free, community-dwelling middle-aged and older adults during an 8-year follow-up.

Design

A community-based longitudinal cohort study.

Setting

Yuanshan township in Yi-Lan County, Taiwan.

Participants

A total of 889 community-dwelling residents aged 50 years or older.

Measurements

Age, sex, educational level, employment status, alcohol status, body mass index, physical activity, gait speed, depressive symptoms, WHO region-specific CVD risk scores (10-year CV risk, low: <10% vs. moderate-to-high: ≥ 10%), Chinese version of the Mini-Mental State Examination (MMSE), verbal memory by the delay-free recall in the Chinese Version Verbal Learning Test (CVVLT), language function by the Boston Naming Test and the category (animal) Verbal Fluency Test, visuospatial function by the Taylor Complex Figure Test, executive function by the digit backward and the Clock Drawing Test.

Results

Compared to those with low CVD risk, middle-aged and older adults with moderate-to-high CVD risk were at greater risk for cognitive impairments with respect to the MMSE (adjusted odds ratio (aOR) 1.60 [95% confidence interval (CI) 1.19–2.15], P=0.002), verbal memory (aOR 1.97 [1.43-2.70], P< 0.001) and language (aOR 1.99 [1.46–2.70], P< 0.001), as well as incident dementia (aOR 2.40 [1.33–4.33], P=0.004). After adjusting for all covariates, CVD risk was not associated with other domains of cognitive impairment.

Conclusions

Among healthy, community-dwelling, middle-aged and older adults, those with moderate-to-high cardiovascular risk burden were significantly associated with incident dementia and global and domain-specific cognitive impairments (verbal memory and language), which suggests the existence of a relationship between early cognitive deficits and CVD risk burden. Further studies are needed to elucidate the pathophysiological mechanism of the link between CVD risk burden and cognitive impairment.

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References

  1. Chen LK. Challenges of promoting healthy aging and healthy longevity in the communities. Arch Gerontol Geriatr. 2022;99:104624. https://doi.org/10.1016/j.archger.2022.104624

    PubMed  Google Scholar 

  2. Chen LK. Urbanization and population aging: Converging trends of demographic transitions in modern world. Arch Gerontol Geriatr. 2022;101:104709. https://doi.org/10.1016/j.archger.2022.104709

    PubMed  Google Scholar 

  3. Chen LK, Lijima K, Shimada H, Arai H. Community re-designs for healthy longevity: Japan and Taiwan examples. Arch Gerontol Geriatr. Published online November 23, 2022:104875. https://doi.org/10.1016/j.archger.2022.104875

  4. Chen YZ, Huang ST, Wen YW, Chen LK, Hsiao FY. Combined Effects of Frailty and Polypharmacy on Health Outcomes in Older Adults: Frailty Outweighs Polypharmacy. J Am Med Dir Assoc. 2021;22(3):606.e7–606.e18. https://doi.org/10.1016/j.jamda.2020.07.019

    PubMed  Google Scholar 

  5. Hu RH, Hsiao FY, Chen LJ, Huang PT, Hsu WWY. Increasing age- and gender-specific burden and complexity of multimorbidity in Taiwan, 2003–2013: a cross-sectional study based on nationwide claims data. BMJ Open. 2019;9(6):e028333. https://doi.org/10.1136/bmjopen-2018-028333

    PubMed Central  PubMed  Google Scholar 

  6. Lai HY, Huang ST, Chen LK, Hsiao FY. Development of frailty index using ICD-10 codes to predict mortality and rehospitalization of older adults: An update of the multimorbidity frailty index. Arch Gerontol Geriatr. 2022;100:104646. https://doi.org/10.1016/j.archger.2022.104646

    PubMed  Google Scholar 

  7. Lin CS, Lee WJ, Lin SY, et al. Subtypes of Premorbid Metabolic Syndrome and Associated Clinical Outcomes in Older Adults. Front Med. 2022;8. Accessed February 3, 2023. https://www.frontiersin.org/articles/10.3389/fmed.2021.698728

  8. Meng LC, Hsiao FY, Huang ST, Lu WH, Peng LN, Chen LK. Intrinsic Capacity Impairment Patterns and their Associations with Unfavorable Medication Utilization: A Nationwide Population-Based Study of 37,993 Community-Dwelling Older Adults. J Nutr Health Aging. 2022;26(10):918–925. https://doi.org/10.1007/s12603-022-1847-z

    PubMed  Google Scholar 

  9. Wen YC, Chen LK, Hsiao FY. Predicting mortality and hospitalization of older adults by the multimorbidity frailty index. PLOS ONE. 2017;12(11):e0187825. https://doi.org/10.1371/journal.pone.0187825

    PubMed Central  PubMed  Google Scholar 

  10. Chen Y, Zhang Y, Li S, et al. Cardiometabolic diseases, polygenic risk score, APOE genotype, and risk of incident dementia: A population-based prospective cohort study. Arch Gerontol Geriatr. 2023;105:104853. https://doi.org/10.1016/j.archger.2022.104853

    CAS  PubMed  Google Scholar 

  11. GBD 2016 Dementia Collaborators. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. Jan 2019;18(1):88–106. https://doi.org/10.1016/s1474-4422(18)30403-4

    Google Scholar 

  12. WHO. Global status report on the public health response to dementia. 2021. https://cdn.who.int/media/docs/default-source/mental-health/dementia/who_dementia-infographic_2021-09-23_dv.pdf?sfvrsn=d9ecdc14_3

  13. Park MB, Kim SM. The influence of cohabitation type on the psychological vulnerability of family caregivers of people with dementia: Results from a community health survey of 324,078 people in Korea. Arch Gerontol Geriatr. 2022;98:104558. https://doi.org/10.1016/j.archger.2021.104558

    PubMed  Google Scholar 

  14. Xu L, Liu Y, He H, Fields NL, Ivey DL, Kan C. Caregiving intensity and caregiver burden among caregivers of people with dementia: The moderating roles of social support. Arch Gerontol Geriatr. 2021;94:104334. https://doi.org/10.1016/j.archger.2020.104334

    PubMed  Google Scholar 

  15. Kalaria RN, Maestre GE, Arizaga R, et al. Alzheimer’s disease and vascular dementia in developing countries: prevalence, management, and risk factors [published correction appears in Lancet Neurol. 2008 Oct;7(10):867]. Lancet Neurol. 2008;7(9):812–26. https://doi.org/10.1016/S1474-4422(08)70169-8

    PubMed Central  PubMed  Google Scholar 

  16. Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective. Alzheimers Dement. 2015;11(6):718–26. https://doi.org/10.1016/j.jalz.2015.05.016

    PubMed  Google Scholar 

  17. Thal DR, Grinberg LT, Attems J. Vascular dementia: different forms of vessel disorders contribute to the development of dementia in the elderly brain. Exp Gerontol. Nov 2012;47(11):816–24. https://doi.org/10.1016/j.exger.2012.05.023

    PubMed Central  PubMed  Google Scholar 

  18. D’Agostino RB, Sr., Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. Feb 12 2008;117(6):743–53. https://doi.org/10.1161/circulationaha.107.699579

    PubMed  Google Scholar 

  19. WHO CVD Risk Chart Working Group. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. Lancet Glob Health. 2019;7(10):e1332–e1345. https://doi.org/10.1016/S2214-109X(19)30318-3

    Google Scholar 

  20. Reitz C, Tang MX, Schupf N, Manly JJ, Mayeux R, Luchsinger JA. A summary risk score for the prediction of Alzheimer disease in elderly persons. Arch Neurol. 2010;67(7):835–841. https://doi.org/10.1001/archneurol.2010.136

    PubMed Central  PubMed  Google Scholar 

  21. Exalto LG, Quesenberry CP, Barnes D, Kivipelto M, Biessels GJ, Whitmer RA. Midlife risk score for the prediction of dementia four decades later. Alzheimers Dement. 2014;10(5):562–570. https://doi.org/10.1016/j.jalz.2013.05.1772

    PubMed  Google Scholar 

  22. Mitnitski A, Skoog I, Song X, et al. A vascular risk factor index in relation to mortality and incident dementia. Eur J Neurol. 2006;13(5):514–521. https://doi.org/10.1111/j.1468-1331.2006.01297.x

    CAS  PubMed  Google Scholar 

  23. Narayan KM, Aviles-Santa L, Oza-Frank R, et al. Report of a National Heart, Lung, And Blood Institute Workshop: heterogeneity in cardiometabolic risk in Asian Americans In the U.S. Opportunities for research. J Am Coll Cardiol. Mar 9 2010;55(10):966–73. https://doi.org/10.1016/j.jacc.2009.07.075

    PubMed  Google Scholar 

  24. Dubois B, Feldman HH, Jacova C, et al. Revising the definition of Alzheimer’s disease: a new lexicon. The Lancet Neurology. 2010;9(11):1118–27. https://doi.org/10.1016/s1474-4422(10)70223-4

    PubMed  Google Scholar 

  25. Cholerton B, Baker LD, Craft S. Insulin, cognition, and dementia. Eur J Pharmacol. 2013;719(1–3):170–179. https://doi.org/10.1016/j.ejphar.2013.08.008

    CAS  PubMed Central  PubMed  Google Scholar 

  26. Song R, Xu H, Dintica CS, et al. Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline. J Am Coll Cardiol. 2020;75(20):2525–2534. https://doi.org/10.1016/j.jacc.2020.03.053

    PubMed Central  PubMed  Google Scholar 

  27. Song R, Pan KY, Xu H, et al. Association of cardiovascular risk burden with risk of dementia and brain pathologies: A population-based cohort study. Alzheimers Dement. Dec 2021;17(12):1914–22. https://doi.org/10.1002/alz.12343

    PubMed Central  PubMed  Google Scholar 

  28. Zeki Al Hazzouri A, Haan MN, Neuhaus JM, et al. Cardiovascular risk score, cognitive decline, and dementia in older Mexican Americans: the role of sex and education. J Am Heart Assoc. Apr 22 2013;2(2):e004978.

    PubMed  Google Scholar 

  29. Harrison SL, Ding J, Tang EYH, et al. Cardiovascular Disease Risk Models and Longitudinal Changes in Cognition: A Systematic Review. PLoS One. 2014;9(12):e114431. https://doi.org/10.1371/journal.pone.0114431

    PubMed Central  PubMed  Google Scholar 

  30. Li HW, Lee WJ, Lin MH, et al. Quality of Life among Community-Dwelling Middle-Aged and Older Adults: Function Matters More than Multimorbidity. Arch Gerontol Geriatr. 2021;95:104423. https://doi.org/10.1016/j.archger.2021.104423

    PubMed  Google Scholar 

  31. Chung CP, Lee WJ, Chou KH, et al. Frailty and dementia risks in asymptomatic cerebral small vessel disease: A longitudinal cohort study. Arch Gerontol Geriatr. 2022;102:104754. https://doi.org/10.1016/j.archger.2022.104754

    PubMed  Google Scholar 

  32. Lee WJ, Peng LN, Lin MH, et al. Six-year transition of physio-cognitive decline syndrome: Results from I-Lan Longitudinal Aging Study. Arch Gerontol Geriatr. 2022;102:104743. https://doi.org/10.1016/j.archger.2022.104743

    PubMed  Google Scholar 

  33. Liu LK, Chen CH, Lee WJ, et al. Cognitive Frailty and Its Association with All-Cause Mortality Among Community-Dwelling Older Adults in Taiwan: Results from I-Lan Longitudinal Aging Study. Rejuvenation Res. 2018;21(6):510–517. https://doi.org/10.1089/rej.2017.2038

    PubMed  Google Scholar 

  34. Liu LK, Lee WJ, Liu CL, et al. Age-related skeletal muscle mass loss and physical performance in Taiwan: implications to diagnostic strategy of sarcopenia in Asia. Geriatr Gerontol Int. 2013;13(4):964–971. https://doi.org/10.1111/ggi.12040

    PubMed  Google Scholar 

  35. American Diabetes Association. Diagnosis and classification of diabetes mellitus [published correction appears in Diabetes Care. 2010 Apr;33(4):e57]. Diabetes Care. 2010;33 Suppl 1(Suppl 1):S62–S69. https://doi.org/10.2337/dc10-S062

    PubMed Central  Google Scholar 

  36. Guo N, Liu H, Wang P, et al. Chinese version and norms of the Mini-Mental State Examination. Taiwan Journal of Physical Medicine and Rehabilitation. 1988;16:52–59.

    Google Scholar 

  37. Chang CC, Kramer JH, Lin KN, et al. Validating the Chinese version of the Verbal Learning Test for screening Alzheimer’s disease. J Int Neuropsychol Soc. 2010;16(2):244–251. https://doi.org/10.1017/S1355617709991184

    PubMed  Google Scholar 

  38. Suzuki Y, Mochizuki H, Oki M, et al. Quantitative and Qualitative Analyses of the Clock Drawing Test in Fall and Non-Fall Patients with Alzheimer’s Disease. Dement Geriatr Cogn Dis Extra. 2019;9(3):381–388. Published 2019 Dec 20. https://doi.org/10.1159/000502089

    PubMed Central  PubMed  Google Scholar 

  39. Sachdev PS, Blacker D, Blazer DG, et al. Classifying neurocognitive disorders: the DSM-5 approach. Nature Reviews Neurology. 2014;10(11):634–42. https://doi.org/10.1038/nrneurol.2014.181

    PubMed  Google Scholar 

  40. Dubois B, Feldman HH, Jacova C, et al. Revising the definition of Alzheimer’s disease: a new lexicon. The Lancet Neurology. 2010;9(11):1118–27. https://doi.org/10.1016/s1474-4422(10)70223-4

    PubMed  Google Scholar 

  41. Jetté M, Sidney K, Blümchen G. Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin Cardiol. Aug 1990;13(8):555–65. https://doi.org/10.1002/clc.4960130809

    PubMed  Google Scholar 

  42. Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300–307.e2. https://doi.org/10.1016/j.jamda.2019.12.012

    PubMed  Google Scholar 

  43. Chan AC. Clinical validation of the Geriatric Depression Scale (GDS): Chinese version. J Aging Health. 1996;8(2):238–253. https://doi.org/10.1177/089826439600800205

    CAS  PubMed  Google Scholar 

  44. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. *J Gerontol A Biol Sci Med Sci*. 2001;56(3):M146–M156. doi:https://doi.org/10.1093/gerona/56.3.m146

    CAS  PubMed  Google Scholar 

  45. Li X, Wu C, Lu J, et al. Cardiovascular risk factors in China: a nationwide population-based cohort study [published correction appears in Lancet Public Health. 2021 May;6(5):e271]. Lancet Public Health. 2020;5(12):e672–e681. [https://doi.org/10.1016/S2468-2667(20)30191-2](https://doi.org/10.1016/S2468-2667(20)301912)

    PubMed  Google Scholar 

  46. Song R, Xu H, Dintica CS, et al. Associations Between Cardiovascular Risk, Structural Brain Changes, and Cognitive Decline. J Am Coll Cardiol. May 26 2020;75(20):2525–34. https://doi.org/10.1016/j.jacc.2020.03.053

    PubMed Central  PubMed  Google Scholar 

  47. Jia L, Du Y, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. Lancet Public Health. Dec 2020;5(12):e661–e71. doi:https://doi.org/10.1016/S2468-2667(20)30185-7

    PubMed  Google Scholar 

  48. Makino K, Lee S, Bae S, et al. Absolute Cardiovascular Disease Risk Is Associated With the Incidence of Non-amnestic Cognitive Impairment in Japanese Older Adults. Front Aging Neurosci. 2021;13:685683. Published 2021 Jun 14. https://doi.org/10.3389/fnagi.2021.685683

    PubMed Central  PubMed  Google Scholar 

  49. Farnsworth von Cederwald B, Josefsson M, Wáhlin A, Nyberg L, Karalija N. Association of Cardiovascular Risk Trajectory With Cognitive Decline and Incident Dementia. Neurology. 2022;98(20):e2013–e2022. https://doi.org/10.1212/WNL.0000000000200255

    CAS  PubMed Central  PubMed  Google Scholar 

  50. Song R, Pan KY, Xu H, et al. Association of cardiovascular risk burden with risk of dementia and brain pathologies: A population-based cohort study. Alzheimers Dement. Dec 2021;17(12):1914–22. https://doi.org/10.1002/alz.12343

    PubMed Central  PubMed  Google Scholar 

  51. Kelaiditi E, Cesari M, Canevelli M et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging 2013;17: 726–734

    CAS  PubMed  Google Scholar 

  52. Liu LK, Chen CH, Lee WJ, et al. Cognitive Frailty and Its Association with All-Cause Mortality Among Community-Dwelling Older Adults in Taiwan: Results from I-Lan Longitudinal Aging Study. *Rejuvenation Res*. 2018;21(6):510–517. doi:https://doi.org/10.1089/rej.2017.2038

    PubMed  Google Scholar 

  53. Chung CP, Lee WJ, Peng LN, et al. Physio-Cognitive Decline Syndrome as the Phenotype and Treatment Target of Unhealthy Aging. *J Nutr Health Aging*. 2021;25(10):1179–1189. doi:https://doi.org/10.1007/s12603-021-1693-4

    PubMed  Google Scholar 

  54. Lee WJ, Peng LN, Lin MH, et al. Six-year transition of physio-cognitive decline syndrome: Results from I-Lan Longitudinal Aging Study. *Arch Gerontol Geriatr*. 2022;102:104743. doi:https://doi.org/10.1016/j.archger.2022.104743

    PubMed  Google Scholar 

  55. Zeki Al Hazzouri A, Haan MN, Neuhaus JM, et al. Cardiovascular risk score, cognitive decline, and dementia in older Mexican Americans: the role of sex and education. J Am Heart Assoc. Apr 22 2013;2(2):e004978. https://doi.org/10.1161/jaha.113.004978

    PubMed  Google Scholar 

  56. Sweeney MD, Montagne A, Sagare AP, et al. Vascular dysfunction-The disregarded partner of Alzheimer’s disease [published correction appears in Alzheimers Dement. 2022 Mar;18(3):522]. Alzheimers Dement. 2019;15(1):158–167. https://doi.org/10.1016/j.jalz.2018.07.222

    PubMed Central  PubMed  Google Scholar 

  57. Nation DA, Sweeney MD, Montagne A, et al. Blood-brain barrier breakdown is an early biomarker of human cognitive dysfunction. Nat Med. 2019;25(2):270–276. https://doi.org/10.1038/s41591-018-0297-y

    CAS  PubMed Central  PubMed  Google Scholar 

  58. Claassen JAHR, Thijssen DHJ, Panerai RB, Faraci FM. Regulation of cerebral blood flow in humans: physiology and clinical implications of autoregulation. Physiol Rev. 2021;101(4):1487–1559. https://doi.org/10.1152/physrev.00022.2020

    CAS  PubMed Central  PubMed  Google Scholar 

  59. van Sloten TT, Sedaghat S, Carnethon MR, Launer LJ, Stehouwer CDA. Cerebral microvascular complications of type 2 diabetes: stroke, cognitive dysfunction, and depression. Lancet Diabetes Endocrinol. 2020;8(4):325–336. [https://doi.org/10.1016/S2213-8587(19)30405-X](https://doi.org/10.1016/S2213-8587(19)30405-X)

    CAS  PubMed  Google Scholar 

  60. Lee ES, Yoon JH, Choi J, Andika FR, Lee T, Jeong Y. A mouse model of subcortical vascular dementia reflecting degeneration of cerebral white matter and microcirculation. J Cereb Blood Flow Metab. 2019;39(1):44–57. https://doi.org/10.1177/0271678X17736963

    PubMed  Google Scholar 

  61. Han F. Cerebral microvascular dysfunction and neurodegeneration in dementia. Stroke Vasc Neurol. 2019;4(2):105–107. Published 2019 Jun 24. https://doi.org/10.1136/svn-2018-000213

    PubMed Central  PubMed  Google Scholar 

  62. Ma Y, Sajeev G, VanderWeele TJ, et al. APOE ε4 and late-life cognition: mediation by structural brain imaging markers. Eur J Epidemiol. Jun 2022;37(6):591–601. https://doi.org/10.1007/s10654-022-00864-7

    PubMed Central  PubMed  Google Scholar 

  63. Belleville, S., Fouquet, C., Hudon, C. et al. Neuropsychological Measures that Predict Progression from Mild Cognitive Impairment to Alzheimer’s type dementia in Older Adults: a Systematic Review and Meta-Analysis. Neuropsychol Rev 27, 328–353 (2017). https://doi.org/10.1007/s11065-017-9361-5

    PubMed Central  PubMed  Google Scholar 

  64. Tseng, SH., Liu, LK., Peng, LN. et al. Development and Validation of a Tool to Screen for Cognitive Frailty Among Community-Dwelling Elders. J Nutr Health Aging 23, 904–909 (2019). https://doi.org/10.1007/s12603-019-1235-5

    PubMed  Google Scholar 

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Acknowledgments

The authors thank all participants of the study as well as members of the staff of the ILAS study for their role in data collection.

Funding

The study was funded by the National Science and Technology Council of Taiwan (NSTC 111-2622-8-A49-019-IE; NSTC 111-2321-B-A49-008).

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Authors and Affiliations

  1. Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, Taiwan

    Y.-H. Lee, L.-N. Peng, M.-H. Lin & Liang-Kung Chen

  2. Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan

    W.-J. Lee

  3. Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Y.-H. Lee, W.-J. Lee, L.-N. Peng, M.-H. Lin & Liang-Kung Chen

  4. Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan

    F.-Y. Hsiao

  5. School of Pharmacy, National Taiwan University, Taipei, Taiwan

    F.-Y. Hsiao

  6. Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan

    F.-Y. Hsiao

  7. Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan

    Liang-Kung Chen

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  1. Y.-H. Lee
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Correspondence to Liang-Kung Chen.

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Conflict of interest: The authors declare that they have no financial interests, relationships, or affiliations relevant to the subject of this manuscript.

Ethical standard: The whole study was approved by the Institutional Board Review of National Yang Ming Chiao Tung University (YM103008) and Taipei Veterans General Hospital (2018-05-003B), and all participants signed a written informed consent form before enrollment.

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Lee, YH., Lee, WJ., Peng, LN. et al. Cardiovascular Disease Risk Burden, Cognitive Impairments and Incident Dementia among Community-Dwelling Middle-Aged and Older Adults: An 8-Year Longitudinal Follow-up Study. J Nutr Health Aging 27, 641–648 (2023). https://doi.org/10.1007/s12603-023-1954-5

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