Midlife CV Conditions, Risk Factors Linked to Cognitive Decline

Nan Huo, M.D., Ph.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues evaluated 1,857 participants enrolled in the Mayo Clinic Study of Aging (aged 50 to 69 years at baseline). Every 15 months, participants underwent neurologic evaluation and neuropsychological testing. The association between baseline cardiovascular conditions or risk factors and global and domain-specific cognitive decline was assessed.

Overall, 78.9 percent of the participants had at least one cardiovascular condition or risk factor (83.4 percent of men and 74.5 percent of women). The researchers found that in multivariable models, cross-sectionally, coronary heart disease and ever smoking were associated with a lower visuospatial z-score. Longitudinally, there were associations for several cardiovascular conditions and risk factors with declines in global and/or domain-specific z-scores, but not visuospatial z-scores. The associations for most cardiovascular conditions with cognition were stronger among women; associations with global cognition decline were only seen in women for coronary heart disease and other cardiovascular conditions. Furthermore, associations with language z-score decline were seen for diabetes, dyslipidemia, and coronary heart disease in women only. Congestive heart failure, however, was only associated with language z-score decline in men.

"Middle-aged adults, especially women, with some cardiovascular conditions or risk factors, such as hypertension and diabetes mellitus, may represent critical subgroups for early monitoring," the authors write.