Neurodegeneration and Cardiovascular Health: New Insights on Racial Differences

A COHORT study of 1,018 older adults has found that better cardiovascular health (CVH) is associated with 19% lower levels of neurofilament light chain (NfL), a key biomarker of neurodegeneration, though no link was observed with total tau (t-tau).

Cardiovascular health is increasingly recognised as a critical factor in brain ageing, with shared risk factors between heart disease and neurodegenerative conditions such as Alzheimer’s. This study, part of the Chicago Health and Aging Project (CHAP), investigated how adherence to the American Heart Association’s Life’s Simple 7—a seven-component metric for CVH—impacts biomarkers of neurodegeneration. The findings highlight the potential for cardiovascular interventions to mitigate neurodegenerative disease burden, particularly in high-risk populations.

The study analysed 1,018 participants aged 65+ (mean age 73.1, 61.4% female, 59.9% Black) with serum NfL and t-tau measurements. CVH scores (0–14 points) were calculated based on diet, exercise, smoking status, BMI, and management of dyslipidemia, diabetes, and hypertension. Participants with high CVH scores (10–14 points) had 18.9% lower NfL levels compared to those with low scores (0–6 points) (β=−0.091, SE=0.025). High CVH also slowed annual NfL increases by 1.7% (β=−0.008, SE=0.004). Notably, 64.3% of high-CVH individuals were White, reflecting disparities in CVH attainment. No association was found between CVH and t-tau, likely due to t-tau’s limited reliability as a neurodegeneration marker. Black participants, despite higher baseline cardiovascular risk, showed comparable biomarker benefits from improved CVH.

These results underscore the importance of prioritising CVH in older adults to reduce neurodegeneration risks, particularly in Black communities disproportionately affected by cardiovascular disease. For clinical practice, integrating Life’s Simple 7 into routine care could slow NfL accumulation, potentially delaying cognitive decline. Future research should explore interventions targeting CVH improvements in diverse populations and investigate additional biomarkers like amyloid-beta. Public health initiatives must address barriers to CVH equity, ensuring access to dietary, exercise, and vascular risk management resources across all demographics.

Katrina Thornber, EMJ

Reference

Dhana A et al. Cardiovascular health and biomarkers of neurodegenerative disease in older adults. JAMA Netw Open. 2025;8(3):e250527.