Accelerated Biological Aging and Longitudinal Progression of Cardiometabolic Disease, Subsequent Dementia, and Death: A Multistate Analysis

May 28, 2025European journal of neurology

Faster Biological Aging Linked to the Progression of Heart and Metabolic Diseases, Later Dementia, and Death Over Time

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Abstract

Over a median follow-up of 13.7 years, 47,150 participants developed cardiometabolic disease (CMD).

  • Biologically older participants showed higher risks of progressing from health to CMD, then to post-CMD dementia, and ultimately to death.
  • Each standard deviation increase in KDM- acceleration was associated with a 34% higher risk of transitioning from baseline to CMD.
  • acceleration was linked to a 19% increased risk of moving from baseline to CMD.
  • KDM-BA acceleration was associated with a 12% increased risk of transitioning from CMD to post-CMD dementia.
  • Both BA accelerations were more strongly linked to the transition from CMD to post-CMD vascular dementia compared to post-CMD Alzheimer's disease.

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Key numbers

1.34
Increase in CMD Risk
Adjusted hazard ratio for KDM- acceleration from baseline to CMD.
1.12
Transition to Post-CMD Dementia Risk
Adjusted hazard ratio for KDM- acceleration from CMD to post-CMD dementia.
1.22
Post-CMD VaD Transition Risk
Adjusted hazard ratio for KDM- acceleration from CMD to post-CMD vascular dementia.

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