Literature Review

Cardiovascular Health May Prevent Cognitive Decline


 

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The closer that older adults come to meeting the American Heart Association’s (AHA’s) ideal targets for seven factors that determine cardiovascular health, the lower their risk for cognitive decline, according to a report published online March 16 in the Journal of the American Heart Association.

A secondary analysis of data from a prospective population-based cohort study of stroke risk demonstrated that better alignment with the AHA’s “Life’s Simple 7” cardiovascular health metrics correlated with less decline in mental processing speed, and, to a lesser extent, in executive function and episodic memory. “The results of this study suggest that achievement of the AHA’s ideal cardiovascular health metrics may have benefits for brain health, in addition to preventing strokes and myocardial infarctions, ... underscoring the importance of public health initiatives aimed to better control these seven factors,” said Hannah Gardener, ScD, of the Department of Neurology at the University of Miami, and her associates.

Hannah Gardener, ScD

The AHA recently defined ideal target levels for seven modifiable cardiovascular risk factors: smoking status, BMI, physical activity level, diet, blood pressure, total cholesterol level, and fasting glucose level. Meeting or closely approaching these ideals has already been linked to a decreased risk of stroke and myocardial infarction. To examine a possible association with brain health, Dr. Gardener and her colleagues assessed these seven metrics in an ethnically diverse cohort of 722 participants, age 50 and older, in the Northern Manhattan Study. Participants underwent serial comprehensive neuropsychologic testing, including brain MRI.

Of the total cohort, 3% had no ideal factors, 15% had one factor, 33% had two factors, 30% had three factors, 14% had four factors, 14% had five factors, 1% had six factors, and none of the participants had all seven factors. “An increasing number of ideal cardiovascular health factors was positively associated with processing speed,” and the association was particularly strong for three of the factors: BMI, lack of smoking, and ideal fasting glucose level. This association persisted when the data were adjusted to account for MRI markers of subclinical vascular damage, such as abnormalities in white matter volume, brain atrophy, and previous infarctions. A similar but weaker association was seen between an increasing number of ideal cardiovascular health factors and performance on measures of episodic memory and executive function.

These seven cardiovascular factors also were associated with less decline over time in these three areas of cognitive function. In contrast, the cardiovascular factors showed no association with measures of semantic memory, the investigators said.The associations remained unchanged in sensitivity analyses that controlled for the presence and severity of depression.

Mary Ann Moon

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