Page 68 - BH-3-3

Brain & Heart Dementia and the heart

play a common role in the development of cardiovascular assessed using structured questionnaires administered by
diseases (CVDs), type 2 diabetes mellitus (DM), and dietitians. Food measures, portions, and models were used
dementia. Peripheral insulin resistance is a well- to ensure an accurate assessment of dietary patterns.
1-5
documented, independent risk factor for the pathogenesis Each participant underwent a physician-conducted
of CVD, type 2 DM, cancer, and cellular senescence. More clinical examination, including blood pressure (BP)
6
recently, neuronal damage has also been identified as an measurement with a sphygmomanometer and blood
insulin-responsive mechanism, where insulin acts as a testing. Dementia and its risk factors, as stated in the
9
regulator of neuronal metabolism. 2-4,7 Global Burden of Disease study, were identified using a
12
Apart from insulin resistance, failure to consume modified version of an established questionnaire, which
healthy foods and exercise moderately in individuals with incorporated criteria from the World Health Organization
dementia may contribute to the clustering of risk factors, (WHO) and other global agencies. 13
thereby leading to coronary artery disease (CAD). Since
insulin is a protective vasoactive hormone regulating 2.1. Diagnostic criteria for dementia
vascular and neuronal function, insulin resistance can Dementia was diagnosed based on previously established
contribute to vascular dysfunction, leading to hypertension, criteria. Mild memory dysfunction was defined as a score
9
CAD, and potentially exacerbate memory dysfunction. of 21 – 40, indicating possible memory impairment, or 41 –
1-6
60, indicating moderate memory impairment. Alzheimer’s
Many behavioral and metabolic risk factors common to
CVDs are associated with oxidative stress and inflammation, disease was defined if the score was 61 – 80 in the modified
questionnaire.
9
both of which are implicated in dementia. There is
1-7
evidence that excessive caloric intake and accumulation 2.2. Criteria for diagnosis of other risk factors
of visceral fat can induce inflammation and metabolic
syndrome in adipose tissue, further elevating the risk of A Western dietary pattern was defined by a daily intake
CVD and dementia. Dementia is a well-documented exceeding 400 g of processed or refined foods, such
6-8
chronic inflammatory disease, often accompanied by as bread, cake, biscuit, pastry, refined wheat flour, and
insulin resistance; however, no studies to date have directly polished rice. Obesity was classified as a body mass index
2
investigated dementia as a predisposing factor for CAD. (BMI) >30 kg/m , and overweight was defined as a BMI
between 25 and 29.9 kg/m .
2
It is hypothesized that systemic inflammation and
elevated triglyceride levels with dementia may contribute The diagnosis of diabetes DM was based on fasting blood
to CAD through shared pathophysiological mechanisms glucose levels exceeding 7.7 mmoL/L (140 mg/dL) or a 2-h
involving insulin resistance and neuroinflammation. postprandial glucose level >11.2 mmoL/L (>200 mg/dL)
6-8
This study proposes that dementia may be an independent after orally consuming 75 g of glucose. Glucose intolerance
was identified when fasting blood glucose levels were
or associated risk factor for CAD.
between 110 and 140 mg/dL or when postprandial levels
2. Methods ranged from 180 to 200 mg/dL.
This population survey was conducted in the urban Tobacco use was recorded for all participants who
areas of Moradabad city, as reported earlier, through the consumed any type of tobacco. Alcohol consumption was
random selection of 20 streets. 9-11 For each selected street, classified based on frequency and quantity: Individuals
participants were randomly chosen from the local voter consuming alcohol more than once a week were identified
registry to recruit 40 – 100 adults aged 25 years and older. as alcohol consumers, while those consuming more than 10
If a selected individual was either under 25 years of age alcoholic drinks per week were categorized as alcoholics.
or unavailable, a replacement was drawn from the same BP measurements were conducted on the right arm,
registry. Of 2,422 eligible urban residents contacted, with participants in a seated position after resting for
220 (9.08%) declined participation. The remaining 2,002 5 min, in accordance with WHO guidelines. All readings
individuals (986 females and 1,016 males) consented to were taken by the same expert using a single mercury
participate in the study. instrument. Hypertension was defined as a systolic BP
Detailed interviews were conducted using pretested of 140 mmHg or higher or a diastolic BP of 90 mmHg or
and validated instruments to assess tobacco use, alcohol higher.
consumption, and dietary intake, following the guidelines The diagnosis of CAD followed the WHO criteria
reported earlier. 9-11 Dietary intake was evaluated through for population studies. This included a history of angina
participant-maintained 3-day food diaries and further pectoris or myocardial infarction with a prior diagnosis

Volume 3 Issue 3 (2025) 2 doi: 10.36922/bh.8426