AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Association of Aortic Valve Stenosis with Incident Dementia: The Atherosclerosis Risk in Communities (ARIC) Study
By Zhang C, Chiu T, Sun D et al.
Introduction: The association between aortic valve stenosis (AS) and incident dementia is not well established, despite mutual risk factors. We hypothesized that individuals with AS have a higher risk of dementia than those without AS in the Atherosclerosis Risk in Communities (ARIC) Study, a community-based cohort study. Methods: Eligible participants at ARIC Visit 5 (2011-2013), which served as the baseline for this analysis, were those who completed echocardiography and were free of pre-existing dementia, atrial fibrillation, stroke, or prior aortic valve surgery. AS, based on echocardiography, was defined and staged according to ACC/AHA guidelines. The severity of AS was classified based on the mean aortic valve pressure gradient and aortic valve area (AVA). Incident dementia through December 31, 2022 was determined by in-person and telephone cognitive assessments and hospital discharge diagnosis codes. Cox proportional hazards models were employed. Results: The mean ± SD Visit 5 age of the study sample (n=5,153) was 75±5 years, with 60% being female and 22% Black individuals. AS was identified in 994 (19%): 15% with aortic valve sclerosis and 4% with mild to severe AS. Over an average of 7.8 years of follow-up, 250 participants with AS (25%) developed dementia, compared to 21% of those without AS (hazard ratio=1.17; 95% CI: 1.01-1.36, p = 0.04), after adjusting for demographics, comorbidities, left atrial volume index (LAVI), and left ventricular ejection fraction (LVEF). The cumulative risk of dementia also was greater with higher baseline AS severity (20.8%, 21.4%, and 30.5% in the mild/normal, moderate, and severe groups, respectively, based on AVA classification); compared in the mild/normal group, participants with severe AS (AVA < 1.0 cm ² ) had 33% higher dementia risk (hazard ratio=1.33; 95% CI: 1.09, 1.61, p=0.05), adjusted for demographics and comorbidities;, this association was attenuated (1.20; 95% CI: 0.98, 1.47, p=0.07) when further adjusted for LAVI and LVEF. Conclusion: Among community-dwelling older adults, the presence and severity of AS are associated with increased risk of dementia.