Adherence to Life's Simple 7 and Cognitive Function Among Older Adults: The National Health and Nutrition Examination Survey 2011 to 2014

Abstract

Background The American Heart Association proposed the Life's Simple 7 (LS7; including diet, physical activity, smoking, body mass index, blood pressure, plasma fasting glucose, total cholesterol) to promote cardiovascular health. Adherence to LS7 has been found to be associated with better cognitive health as well, but the generalizability of previous studies is limited. We aimed to examine the associations of adherence to LS7 and cognitive function among older adults in a nationally representative sample of population. Methods and Results A total of 2585 older adults (≥60 years, 54% female, 80% non-Hispanic White) in the National Health and Nutrition Examination Survey 2011 to 2014 were included for analysis. Components of LS7 were measured, and adherence to LS7 was calculated on the basis of established cutoff points of individual components. Cognitive function was examined using the Consortium to Establish a Registry for Alzheimer's Disease Word List Memory Task (immediate and delayed memory), Digit Symbol Substitution Test (DSST), and Animal Fluency Test. Test-specific and global cognition Z scores were created. Multivariable linear regression models were conducted on the associations of adherence to LS7 with domain-specific and global cognition Z scores. Each incremental point in adherence to LS7 was associated with higher Z scores for global cognition (β=0.05; 95% CI, 0.02-0.07), Digit Symbol Substitution Test (β=0.05; 95% CI, 0.03-0.07), Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest immediate memory (β=0.03; 95% CI, 0.004-0.05), and animal fluency test (β=0.05; 95% CI, 0.02-0.07). Conclusions Greater adherence to LS7 metrics is associated with better cognitive function among older US adults in a nationally representative sample of population.

Keywords: Life’s Simple 7; aging; cognition; lifestyle.

Figure 1. Prevalence of poor, intermediate, and ideal levels achieved in each component of Life’s Simple 7 among US adults aged ≥60 years, NHANES 2011 to 2014.