Hensel, Abby LJ;
Chan, Therese;
Ahmed, Raisa;
Rasaputra, Prabasha;
Skidmore, Becky;
Luo, Hao;
Vetrano, Davide Liborio;
... Hsu, Amy; + view all
(2025)
Cardiovascular disease as a mediator in the relationship between lifestyle risk factors and cognitive outcomes: a scoping review.
Alzheimer's & Dementia
, 21
(10)
, Article e70843. 10.1002/alz.70843.
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Abstract
ADementia is a major global health challenge and lifestyle modification is a key prevention strategy. Cardiovascular disease (CVD) is hypothesized to mediate lifestyle–dementia relationships, but empirical evidence is unclear. Mediation analysis offers insight into causal mechanisms beyond traditional associations. This scoping review synthesizes the limited available studies applying mediation analysis to examine whether CVD mediates associations between lifestyle factors (smoking, alcohol use, diet, physical activity) and cognitive outcomes in adults aged 45 and older. Of 1309 records screened, five studies met the inclusion criteria, reflecting a small, heterogeneous evidence base. Most examined physical activity (n = 4), with two reporting partial mediation by composite CVD risk scores. Evidence for diet (n = 2) and alcohol (n = 1) was inconclusive, and no studies assessed smoking. Overall, evidence for CVD as a mediator remains tentative, sparse, and inconsistent, highlighting major methodological gaps and an urgent need for robust studies to clarify whether cardiovascular health underpins lifestyle-related dementia risk.
| Type: | Article |
|---|---|
| Title: | Cardiovascular disease as a mediator in the relationship between lifestyle risk factors and cognitive outcomes: a scoping review |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/alz.70843 |
| Publisher version: | https://doi.org/10.1002/alz.70843 |
| Language: | English |
| Additional information: | © 2025 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
| Keywords: | aging, cardiovascular diseases, dementia, mediation analysis, risk factors |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10216210 |
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