Cardiovascular diseases and dementia are major public health concern, and they share several risk factors. Dementia-related disorders are the primary cause for long-term care among older adults. By affecting potential modifiable vascular risk factors, it is possible to influence the incidence of dementia and thus prevent or postpone the need for long-term care.

This thesis examined secular changes in cardiovascular morbidity, risk factor profiles, and dementia risk indices between the 1920 and the 1940 birth cohorts of home-dwelling older adults at the age of 70 years. Additionally, the association with the Brief Dementia Risk Index and incidence of dementia during a five-year follow-up was assessed. Factors predicting need for long-term care were examined among the 1920 cohort, and the future need for long-term care was predicted among the 1940 birth cohort.
The 1940 birth cohort had lower cardiovascular disease morbidity, and their dementia risk and future need for long-term care were lower compared with the 1920 birth cohort. Of the cardiovascular risk factors, blood pressure and cholesterol values declined in the 1940 birth cohort, but the prevalence of diabetes and obesity increased compared with the 1920 birth cohort. The main predictors for need of long-term care were cognitive decline and reduced physical function. The Brief Dementia Risk Index predicted incident dementia during a five-year follow-up among the 1940 birth cohort.

The findings suggest that by influencing the modifiable risk factors for cardiovascular diseases and dementia, it is possible to reduce the need for long-term care. It is unclear if the increased use of cardiovascular medications will compensate the increased cardiovascular risk due to diabetes and obesity. Despite better general health and cognitive performance among the 1940 birth cohort, the predicted rates of future need for long-term care were high, especially at the ages of 85 and 90 years among those with impaired cognitive or physical function.