Cardiometabolic morbidities and dementia

Cardiometabolic morbidities and dementia are increasingly common as people age. In this chapter, we summarize the epidemiological literature concerning: (1) mixed dementia due to cerebrovascular and neurodegenerative lesions as the most common form of dementia in older people; (2) the relation of cardiovascular disease with cognitive decline and dementia and the underlying pathophysiological mechanisms; and (3) cardiovascular comorbidities in dementia and impact on dementia care and prognosis. Atherosclerotic and arteriosclerotic disorders resulting from long-term exposures to cardiovascular risk factors, together with neurodegeneration in brain ageing, contribute to accelerated cognitive decline and dementia. The heart-brain connection in ageing has implications for dementia interventions. Furthermore, cardiovascular comorbidities in dementia contribute to poor outcomes, create complex challenges for dementia care, and substantially increase social care costs of dementia. Thus, early recognition and management of cardiovascular comorbidities in dementia may help health and social care providers maximize the well-being of people with dementia.