中年期の心臓の健康状態が認知症リスクに関連(Poorer heart health in middle age linked to increased dementia risk)

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2025-11-06 ユニバーシティ・カレッジ・ロンドン(UCL)

ユニバーシティ・カレッジ・ロンドン(UCL)の研究で、中年期の心臓の健康状態が将来の認知症発症リスクに強く関係することが明らかになった。研究では、45~69歳の約6,000人を25年間追跡し、血中の心筋損傷マーカー「トロポニンI」濃度と認知症発症率を解析。その結果、トロポニンI値が高い人は最も低い人に比べ認知症リスクが約38%高かった。また、15年後に実施した脳MRIでは、高トロポニン群で海馬や灰白質の萎縮が顕著に見られ、脳年齢が平均で約3歳進んでいることが示唆された。研究者は、心臓と脳の健康が密接に連動しており、中年期の高血圧、肥満、喫煙、高コレステロールなどの心血管リスク管理が、認知症予防にもつながると指摘。心血管の早期異常を示すトロポニン測定は、将来の認知症リスクを予測する有効な検査となる可能性があると結論づけた。

<関連情報>

高感度心筋トロポニンIと認知症リスク:25年間の縦断的ホワイトホールII研究 High-sensitivity cardiac troponin I and risk of dementia: the 25-year longitudinal Whitehall II study

Yuntao Chen, Martin Shipley, Atul Anand, Dorien M Kimenai, Klaus P Ebmeier, Severine Sabia, Archana Singh-Manoux, John Deanfield, Mika Kivimaki, Gill Livingston …
European Heart Journal  Published:06 November 2025
DOI:https://doi.org/10.1093/eurheartj/ehaf834

中年期の心臓の健康状態が認知症リスクに関連(Poorer heart health in middle age linked to increased dementia risk)
Structured Graphical Abstract

Abstract

Background and Aims

This study hypothesizes that subclinical myocardial injury during midlife, indexed by increases in cardiac troponin I, is associated with accelerated cognitive decline, smaller structural brain volume, and higher risk of dementia.

Methods

Overall, 5985 participants in the Whitehall II study, aged 45–69 who had cardiac troponin I measured by a high-sensitivity assay at baseline (1997–99), were followed until March 2023. The outcome measure was incident dementia; cognitive testing was performed at six waves; and neuroimaging metrics were obtained from magnetic resonance imaging scans in 2012–16. Cox model and linear mixed model were used to examine the association of cardiac troponin with incident dementia and cognitive trajectory. A nested case–control sample of 3475 participants (695 dementia cases and 2780 matched controls) was used for backward trajectory analysis for cardiac troponin, measured at three waves (1997–99, 2007–09, 2012–13).

Results

A total of 606 (10.1%) cases of dementia were recorded over a median follow-up of 24.8 years. Doubling of cardiac troponin was associated with 10% (95% confidence interval 3%–17%) higher risk of dementia. Participants with increased cardiac troponin at baseline had a faster decline of cognitive function. Participants with dementia had increased cardiac troponin concentrations compared with those without dementia between 7 and 25 years before diagnosis. Compared with those with cardiac troponin levels < 2.5 ng/L at baseline, those with concentrations > 5.2 ng/L had lower grey matter volume and higher hippocampal atrophy 15 years later, equivalent to ageing effects of 2.7 and 3 years, respectively.

Conclusions

Subclinical myocardial injury at midlife was associated with higher dementia risk in later life.

医療・健康
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