You Wenpeng
Adelaide Medical School the University of Adelaide Adelaide South Australia Australia.
School of Nursing and Midwifery Western Sydney University Sydney New South Wales Australia.
Health Sci Rep. 2025 Aug 27;8(9):e71179. doi: 10.1002/hsr2.71179. eCollection 2025 Sep.
Cardiovascular disease (CVD) and dementia represent two of the most pressing global health challenges, particularly in low- and middle-income countries (LMICs). While vascular pathology is increasingly recognized as a contributor to cognitive decline, few studies have systematically explored the global association between CVD and dementia using standardized, population-level data. This study aimed to investigate the relationship between CVD and dementia incidence across 204 countries, stratified by economic status, development level, and geographic region.
Age-standardized incidence rates for cardiovascular disease (CVD) and dementia in 2021 were sourced from the Global Burden of Disease Study. To examine global and regional associations, bivariate analyses (Pearson and Spearman correlations) and partial correlations were conducted, adjusting for ageing, economic affluence, genetic predisposition, and urbanization. Linear and multivariate stepwise regression models were applied to estimate the extent to which CVD incidence contributes to dementia incidence at the population level.
Globally, CVD incidence was significantly associated with dementia incidence (Pearson = 0.777; Spearman = 0.868; < 0.001). CVD explained approximately 43.0% of the variance in dementia incidence at the population level (² = 0.4303), even after adjusting for key confounders. The association was notably stronger in low- and middle-income countries (LMICs) and developing regions. Among CVD subtypes, peripheral arterial disease ( = 0.903), cardiomyopathy ( = 0.869), and atrial fibrillation ( = 0.708) demonstrated the strongest independent associations with dementia incidence. Conversely, rheumatic heart disease exhibited a negative association.
This study demonstrates a robust population-level association between CVD and dementia across global settings, particularly in resource-limited regions. Findings underscore the importance of integrated public health approaches targeting shared vascular risk factors. Given the ecological design, further individual-level, longitudinal research is needed to clarify causal pathways and inform targeted interventions.
心血管疾病（CVD）和痴呆是全球面临的两个最紧迫的健康挑战，在低收入和中等收入国家（LMICs）尤为突出。虽然血管病变越来越被认为是认知衰退的一个因素，但很少有研究使用标准化的人群水平数据系统地探讨CVD与痴呆之间的全球关联。本研究旨在调查204个国家中CVD与痴呆发病率之间的关系，并按经济状况、发展水平和地理区域进行分层。
2021年心血管疾病（CVD）和痴呆的年龄标准化发病率来自全球疾病负担研究。为了研究全球和区域关联，进行了双变量分析（Pearson和Spearman相关性）和偏相关性分析，并对年龄、经济富裕程度、遗传易感性和城市化进行了调整。应用线性和多元逐步回归模型来估计CVD发病率在人群水平上对痴呆发病率的影响程度。
在全球范围内，CVD发病率与痴呆发病率显著相关（Pearson = 0.777；Spearman = 0.868；P < 0.001）。即使在调整了关键混杂因素后，CVD在人群水平上仍能解释约43.0%的痴呆发病率方差（R² = 0.4303）。这种关联在低收入和中等收入国家（LMICs）以及发展中地区尤为明显。在CVD亚型中，外周动脉疾病（R = 0.903）、心肌病（R = 0.869）和心房颤动（R = 0.708）与痴呆发病率的独立关联最强。相反，风湿性心脏病呈现负相关。
本研究表明，在全球范围内，尤其是在资源有限的地区，CVD与痴呆之间存在着强大的人群水平关联。研究结果强调了针对共同血管危险因素采取综合公共卫生方法的重要性。鉴于本研究的生态学设计，需要进一步开展个体水平的纵向研究，以阐明因果途径并为有针对性的干预措施提供依据。
