A new project funded by the EU is aiming to uncover the links between cardiovascular disease (CVD) and mild cognitive impairment (MCI).
Around one third of people living with CVD also have MCI, yet MCI is undiagnosed in an estimated 50-80% of these cases.
The association between the two conditions extends beyond merely sharing well-established risk factors and implies that CVD itself may contribute to MCI, which refers to a stage of cognitive decline greater than normal for a person’s age and education, but not severe enough to impair daily function.
Conversely, dementia is characterised by a progressive decline in cognitive abilities and the ability to live independently.
The overarching ambition of the DORIAN GRAY project is to uncover the mechanisms bridging MCI and CVD, and develop an integrated approach, which aims to promote resilience and improve overall health in the ageing population.
It will start with the analysis of data available in patients with CVD, such as heart failure (HF), in which mechanisms leading to MCI are enhanced, and thereafter the factors aggravating the onset and progression of cognitive impairment in the general population with cardiovascular risk factors (CVRF) will be defined.
Scientific coordinator, Dr Riccardo Proietti of the University of Liverpool, said: “For years, Alzheimer’s Disease (AD) and cerebrovascular dementia were viewed as separate entities. Recent research suggests they may represent a continuum, with overlapping pathways favouring either vascular or parenchymal β-amyloid deposition.
“CVD not only shares risk factors with cognitive impairment (CI) but may also contribute to it, through mechanisms like chronic hypoperfusion, infarcts, and arterial stiffness. However, a unifying theory remains elusive due to the lack of reliable biomarkers for early diagnosis and risk stratification in MCI patients with CVD. The goal of DORIAN GRAY is to develop a neurobiology-based hypothesis linking MCI to CVD, using biomarkers for clinical assessment to inform joint health policies for prevention, while also developing an innovative digital tool that can be used for cognitive enhancement.”
The project will integrate real-world data from multiple sources, including smartwatches, smartphones, tablets, and leverage AI alongside with clinical variables to enable risk stratification and personalised treatment.
This approach can be applied to primary prevention (risk stratification for MCI), secondary prevention (slowing progression toward dementia), and tertiary prevention (reducing the severity of MCI).
This will, in turn, enable the early identification of patterns or ‘fingerprints’ of potential MCI progression, and introduces a paradigm shift in healthcare, applicable to other non-communicable diseases.
A groundbreaking feature of the project is the use of a medical avatar, an innovative technology with vast, yet largely untapped potential in healthcare.
In DORIAN GRAY, avatar-based coaching exergaming (ABCE) — a technology-driven physical activity — will serve as both a cognitive enhancement tool in the exergame component and a lifestyle intervention in the coaching system. Instead of just offering explicit behavioural instructions, ABCE shapes all aspects of a user’s life comprehensively increasing their awareness on physical and mental well-being, positively impacting healthy ageing.
The project will use data from over 300,000 individuals across six countries to develop an AI model for predicting MCI risk and predisposition.