CV Risk Factors Linked to Faster Cognitive Decline in Midlife

Smoking, hypertension, diabetes linked to increased likelihood of accelerated decline five years later

heart and a pump

THURSDAY, July 16, 2020 (HealthDay News) -- Cardiovascular risk factors (CVRFs) are associated with accelerated cognitive decline in midlife, according to a study published online July 15 in Neurology.

Kristine Yaffe, M.D., from the University of California in San Francisco, and colleagues examined the association between CVRFs and midlife cognitive decline among 2,675 black and white middle-aged adults. CVRFs were assessed at baseline and included hypertension, diabetes, obesity, high cholesterol, and current cigarette smoking for 31, 11, 43, 9, and 15 percent, respectively. Cognitive tests of memory, executive function, and processing speed were administered at baseline and five years later.

The researchers found that 5 percent of participants had accelerated cognitive decline over five years. After multivariable adjustment, smoking, hypertension, and diabetes were associated with an increased likelihood of accelerated decline (adjusted odds ratios [95 percent confidence intervals], 1.65 [1.00 to 2.71], 1.87 [1.26 to 2.75], and 2.45 [1.54 to 3.88], respectively), while no associations were seen for obesity and high cholesterol. When stratified by race, the results were similar. With an increasing number of CVRFs, the likelihood of accelerated decline increased (one to two and three or more CVRFs: adjusted odds ratios [95 percent confidence intervals], 1.77 [1.02 to 3.05] and 2.94 [1.64 to 5.28], respectively); increased likelihood of accelerated decline was also seen with a Framingham Coronary Heart Disease Risk Score ≥10 (adjusted odds ratio, 2.29; 95 percent confidence interval, 1.21 to 4.34).

"Middle-aged adults with CVRFs, especially hypertension, diabetes, and current smoking, or those with more than one CVRF, may represent critical subgroups for early monitoring and education," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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