New Research Suggests Combining Genetic and Heart-Health Risks Can Better Predict and Potentially Delay Dementia

A new study led by researchers at the University of California, San Francisco explores how blending genetic information with cardiovascular risk factors can offer a clearer picture of who is likely to develop dementia in the future. The findings are based on data from around 3,500 older adults, none of whom initially had dementia, and provide a more actionable framework for understanding risk—especially since about half of dementia risk comes from factors we can actually change.

Understanding the Study and Its Participants

The research team analyzed data from individuals who were part of two major long-running programs: the National Alzheimer’s Coordinating Center (NACC) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI). The average age of the participants was 75, and although none had dementia at the start, about one in four already had mild cognitive impairment (MCI), a condition that often precedes dementia.

Over the six-year follow-up period, the group experienced two major outcomes:

• About one in seven participants died, and
• Roughly one in four of those who began with normal cognition or MCI progressed to dementia.

Because these datasets include detailed clinical, genetic, and lifestyle information, the researchers were able to examine the combined influence of several risk factors rather than looking at them in isolation.

The Four Key Risk Factors the Study Focused On

The researchers identified four major contributors that significantly shaped dementia risk:

1. Family history — Having a parent or sibling with dementia.
2. APOE4 gene variant — Carrying at least one copy of the APOE4 allele, a well-known genetic risk factor linked to Alzheimer’s disease.
3. Polygenic risk score — A combined measure of many smaller genetic variations, each contributing a tiny amount to dementia risk.
4. Cardiovascular risk score — A measure shaped by conditions like high LDL cholesterol, hypertension, diabetes, and obesity.

The researchers also checked for rare mutations associated with early-onset Alzheimer’s but found none of the participants carried these uncommon genetic variants.

How These Risk Factors Add Up

One of the clearest findings from the study was how these risks accumulate. The more risk categories a person falls into, the higher their overall chance of developing dementia.

• One risk factor increased the likelihood by 27%.
• Two factors raised it by 83%.
• Three factors doubled the risk.
• All four increased the risk fivefold.

This cumulative effect helps explain why some people with a genetic predisposition never develop dementia, while others without strong genetic markers still do.

Why Cardiovascular Health Matters as Much as Genetics

A major takeaway from the study is the prominent role of heart and blood-vessel health in shaping dementia outcomes. Many vascular issues—such as high blood pressure, high cholesterol, diabetes, and obesity—damage the same systems that help supply oxygen-rich blood to the brain.

Unlike genetic traits, cardiovascular risk factors are highly modifiable. That means lifestyle changes, medical treatments, and better disease management may help reduce overall brain damage and, as the researchers suggest, even delay or prevent dementia symptoms.

The study authors noted that while genes account for about half of dementia risk, the rest is related to changeable elements like physical inactivity, hearing loss, and social isolation. This makes prevention strategies not only possible but practical.

The Growing Possibility of Precision Medicine for Dementia

For a long time, dementia—especially Alzheimer’s—couldn’t be diagnosed reliably before symptoms appeared. That left little room for early preventive care. But this picture is changing due to improvements in:

• Blood-based biomarker tests,
• PET scans, and
• Genetic testing technologies.

As these tools become more common, doctors may soon be able to give patients a clearer, personalized understanding of their dementia risk profile.

Imagine a scenario where someone with a family history expresses concern to their doctor. Instead of waiting for symptoms, the doctor could review their genetic data, assess cardiovascular risks, and work with them on proactive steps to protect their brain health.

This type of early, customized care is exactly what researchers mean when they talk about precision medicine—and this study suggests that dementia prevention may eventually follow the same path cancer prevention took years ago.

What This Means for People Worried About Dementia

For individuals with a strong family history or genetic susceptibility, this research is encouraging. Even if someone carries the APOE4 gene or has a high polygenic risk score, improving lifestyle and cardiovascular health still has an impact.

The study highlights the importance of focusing on what we can control:

• Managing blood pressure
• Lowering LDL cholesterol
• Staying physically active
• Treating hearing loss
• Maintaining social connections
• Monitoring blood sugar levels

Many of these habits protect not just the heart but also the brain, which is why neurologists and cardiologists increasingly see dementia as partly a vascular condition.

Additional Context: How Genetics and Heart Health Interact

Research over the last decade has repeatedly shown links between heart disease and dementia. Individuals with hypertension, atherosclerosis, or diabetes face higher risks of both vascular dementia and Alzheimer’s disease. Meanwhile, common genetic risk factors for heart disease (like those linked to coronary artery disease) also show associations with cognitive decline.

The connection makes sense: the brain depends on a constant flow of oxygen-rich blood, and anything that narrows or damages blood vessels disrupts this flow. Over time, this reduces the brain’s resilience and may accelerate neurodegenerative processes.

In this context, the new UCSF findings strengthen the idea that dementia risk is rarely caused by a single factor. Instead, it’s a mix of genetic load, vascular health, and lifestyle influences, all interacting across decades.

Why the Study’s Findings Matter for the Future

The study demonstrates a path toward using risk assessments not simply to forecast dementia but to help clinicians intervene before cognitive decline begins. By understanding each individual’s unique combination of risks, it may be possible to slow or delay the onset of symptoms, especially now that emerging treatments show more effectiveness in early disease stages than late ones.

The researchers also expect genetic data to become even easier to access in the near future, which could make this type of dementia risk evaluation a routine part of primary care.

Final Thought

This study reinforces an essential idea: dementia is not purely destiny. Even when genes play a significant role, modifiable cardiovascular factors offer a powerful opportunity to influence long-term brain health. By integrating genetic and vascular information, scientists are moving closer to a more personalized and hopeful approach to preventing dementia.

Research Paper:
https://doi.org/10.1002/alz.70826