Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 27;96(17):e2212-e2219.
doi: 10.1212/WNL.0000000000011747. Epub 2021 Mar 17.

Cardiovascular Risk Factors Across the Life Course and Cognitive Decline: A Pooled Cohort Study

Kristine Yaffe  1 , Eric Vittinghoff  2 , Tina Hoang  2 , Karen Matthews  2 , Sherita H Golden  2 , Adina Zeki Al Hazzouri  2
Affiliations

Cardiovascular Risk Factors Across the Life Course and Cognitive Decline: A Pooled Cohort Study

Kristine Yaffe et al. Neurology. .

Abstract

Objective: Cardiovascular risk factors (CVRFs) are associated with increased risk of cognitive decline, but little is known about how early adult CVRFs and those across the life course might influence late-life cognition. To test the hypothesis that CVRFs across the adult life course are associated with late-life cognitive changes, we pooled data from 4 prospective cohorts (n = 15,001, ages 18-95).

Methods: We imputed trajectories of body mass index (BMI), fasting glucose (FG), systolic blood pressure (SBP), and total cholesterol (TC) for older adults. We used linear mixed models to determine the association of early adult, midlife, and late-life CVRFs with late-life decline on global cognition (Modified Mini-Mental State Examination [3MS]) and processing speed (Digit Symbol Substitution Test [DSST]), adjusting for demographics, education, and cohort.

Results: Elevated BMI, FG, and SBP (but not TC) at each time period were associated with greater late-life decline. Early life CVRFs were associated with the greatest change, an approximate doubling of mean 10-year decline (an additional 3-4 points for 3MS or DSST). Late-life CVRFs were associated with declines in early late life (<80 years) but with gains in very late life (≥80 years). After adjusting for CVRF exposures at all time periods, the associations for early adult and late-life CVRFs persisted.

Conclusions: We found that imputed CVRFs across the life course, especially in early adulthood, were associated with greater late-life cognitive decline. Our results suggest that CVRF treatment in early adulthood could benefit late-life cognition, but that treatment in very late life may not be as helpful for these outcomes.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Life Course Modeled Trajectories of Cardiovascular Risk Factors
Trajectories of the overall average with 95% confidence intervals in gray shaded areas.
Figure 2
Figure 2. Difference in 10-Year Cognitive Change in Late Life for Elevated vs Normal CVRF Exposures in Early Adulthood, Midlife, and Late Life
(A) Early adulthood. (B) Midlife. (C) Late life. 3MS = modified Mini-Mental State Examination; CVRF = cardiovascular risk factor; DSST = Digit Symbol Substitution Test.
See this image and copyright information in PMC

References

    1. Institute of Medicine. Cognitive Aging: Progress in Understanding and Opportunities for Action. Washington, DC: National Academies Press; 2015. - PubMed
    1. National Academies of Sciences Engineering, and Medicine. Preventing Cognitive Decline and Dementia: A Way Forward. Washington, DC: National Academies Press; 2017. - PubMed
    1. Livingston G, Sommerlad A, Orgeta V, et al. . Dementia prevention, intervention, and care. Lancet 2017;390:2673–2734. - PubMed
    1. Qiu C, Fratiglioni L. A major role for cardiovascular burden in age-related cognitive decline. Nat Rev Cardiol 2015;12:267–277. - PubMed
    1. Testai FD, Gorelick PB. Vascular cognitive impairment and Alzheimer disease: are these disorders linked to hypertension and other cardiovascular risk factors? In: Aiyagari V, Gorelick PB, eds. Hypertension and Stroke: Pathophysiology and Management. Humana Press, Springer International Publishing: 2016; 261–284.

Publication types

Grants and funding