Cardiovascular health through young adulthood and cognitive functioning in midlife

Abstract

Objective To examine the association between overall cardiovascular health as recently defined by the American Heart Association in young adulthood to middle-age and cognitive function in midlife. Overall ideal cardiovascular health incorporates 7 metrics, including the avoidance of overweight or obesity, a healthful diet, nonsmoking, and physical activity, total cholesterol, blood pressure, and fasting glucose at goal levels. Methods This analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a multicenter community-based study with 25 years of follow-up, included 2,932 participants aged 18 to 30 years at baseline (Year 0) who attended follow-up exams at Years 7 and 25. Cardiovascular health metrics were measured at each examination. The Digit Symbol Substitution Test (DSST), modified Stroop Test, and Rey Auditory Verbal Learning Test (RAVLT) were completed at Year 25. Results A greater number of ideal cardiovascular metrics in young adulthood and middle-age was independently associated with better cognitive function in midlife (p-trend<0.01, for all). Specifically, each additional ideal metric was associated with 1.32 more symbols on the DSST (95% CI: 0.93 to 1.71), a 0.77-point lower interference score on the Stroop Test (−1.03 to −0.45), and 0.12 more words on the RAVLT (0.04 to 0.20). Participants who had ≥5 ideal metrics at a greater number of the 3 examinations over the 25-year period exhibited better performance on each cognitive test in middle-age (p-trend<0.01, for all). Interpretation Ideal cardiovascular health in young adulthood and its maintenance to middle-age is associated with better psychomotor speed, executive function, and verbal memory in midlife.

Association Between Life's Simple 7 and Noncardiovascular Disease: The Multi‐Ethnic Study of Atherosclerosis

“…Numerous studies have established that higher numbers of ideal LS7 metrics or higher LS7 scores are strongly associated with favorable outcomes 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14. Our results are comparable to the findings of prior studies that have shown an inverse relationship between higher LS7 scores and the incidence of non‐CVD 15, 16, 17, 18, 19. In the ARIC study, Rasmussen‐Torvik et al demonstrated that participants with 6 or 7 ideal metrics had a 51% lower risk of cancer compared with those with 0 to 2 ideal metrics 15…”

“…The inverse relationship between ideal CVH and CVD incidence is well documented 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14. However, research exploring the association between ideal CVH and non‐CVDs has just begun 15, 16, 17, 18, 19…”

Achieving and Maintaining Cardiovascular Health Across the Lifespan

“…This relationship remained significant even after excluding smoking status from the ideal health score. Similar prospective benefits in important noncardiovascular outcomes have also been demonstrated for cognition [14], depressive symptoms [15], and health-related quality of life [16]. These data solidify the case that better CVH is associated with overall healthier longevity.…”

Ideal Cardiovascular Health and Biomarkers of Subclinical Brain Aging: The Northern Manhattan Study

“…The Life's Simple 7 metric is appealing from a public health perspective given that it can easily be measured, monitored, and modified, and several epidemiological studies have shown its strong predictive relationship with vascular disease morbidity and mortality, cognitive decline, and dementia 3, 4, 5, 6, 7, 8. For example, in the NOMAS (Northern Manhattan Study), we found that participants who achieved more ideal CVH metrics had better cognitive performance and less decline over time,5 in addition to a lower risk of stroke, myocardial infarction, and vascular‐related death 6.…”