The impact of cardiovascular risk factors on cognition in Hispanics and non-Hispanic whites

Abstract

Among non-Hispanic whites, cardiovascular risk factors are associated with increased mortality and poorer cognition. Prevalence of cardiovascular risk factors among aging Hispanics is also high and Hispanics generally have poorer access to healthcare, yet they tend to have advantageous cardiovascular disease rates and outcomes and live longer than non-Hispanic whites, an epidemiological phenomenon commonly referred to as the Hispanic or Latino health paradox. Although robust data support these ethnic benefits on physical health and mortality, it is unknown if it extends to include cognition resilience advantages in older adulthood. The present study compared relationships between cardiovascular risk and cognition (executive functions and episodic memory) in late middle age and older Hispanics (n = 87) and non-Hispanic whites (n = 81). Participants were selected from the National Alzheimer's Coordinating Center and Alzheimer's Disease Neuroimaging Initiative databases. Hispanics and non-Hispanic white groups were matched on age (50-94 yr, mean age = 72 yr), education, gender, cognitive status (i.e., cognitively healthy versus mildly cognitively impaired), and apolipoprotein E4 status. History of hypertension and higher body mass index were both associated with poorer executive functions among Hispanics but not non-Hispanic whites. Our findings suggest greater vulnerability to impairments in executive functions among Hispanics with hypertension and obesity, contrary to the notion of a Hispanic health paradox for cognitive aging.

Figure 1.

Average Trails B/A scores for normotensive and hypertensive Hispanics (left) and normotensive and hypertensive non-Hispanic whites (right). Hypertensive Hispanics had higher average Trails B/A scores compared to normotensive Hispanics and hypertensive non-Hispanic whites. Note, the overall interaction was marginal (F_(1,154) = 3.55, P = 0.06). Higher Trails B/A scores reflect poorer task switching abilities. Normotensives are represented in white. Hypertensives are represented in gray. (*) P < 0.05.

Figure 2.

Pearson correlations and percent variance explained (R²) between Digit Span Backward raw scores and BMI per ethnic group. Among Hispanics, higher BMI was associated with lower Digit Span Backward scores, (r(60) = −0.34, P < 0.01). BMI was not associated with scores among non-Hispanic whites (r(62) = .17, n.s.). Hispanics are represented by open dots and a solid line. Non-Hispanic whites are represented by shaded diamonds and a dashed line.