In the JournalsPerspective

Healthy heart linked to less age-related cognitive decline

More ideal CV health factors are associated with less cognitive decline in older adults, researchers reported in the Journal of the American Heart Association.

Hannah Gardener, Sc D, assistant scientist in neurology at the Miller School of Medicine at University of Miami, and colleagues assessed the CV health of 1,033 participants in the Northern Manhattan Study. The researchers used the American Heart Association’s “Life’s Simple Seven” metric and then measured their memory, executive functioning and brain processing speed with domain-specific z scores at the beginning and end of the study. Of the 1,033 participants, 722 returned for the follow-up cognitive testing approximately 6 years later.

Hannah Gardener

The Life’s Simple Seven definition of CV health includes tobacco avoidance and ideal levels of weight, physical activity, healthy diet, BP, cholesterol and glucose.

Participants in the Northern Manhattan Study were predominately Hispanic (mean age, 72 years). Most participants had achieved two or three ideal CV health factors. Three percent of the participants had no ideal factors, and no participant achieved all seven ideal factors.

Gardener and colleagues observed that participants who had more ideal CV health factors, especially BMI, fasting glucose and nonsmoking status at initial assessment, were more likely to have better brain processing speed at the start of the study and less decline specifically in executive function and episodic memory at follow-up.

In addition, participants with more ideal CV health scores were associated with less decline in the processing speed domain at follow-up, even after adjusting for MRI markers of subclinical vascular damage.

Episodic memory performance and executive function were also affected by the number of ideal CV health factors achieved, but the association was only significant in those who had no cognitive impairment at baseline. No changes were observed in semantic memory performance.

In subsequent sensitivity analyses, systolic BP was inversely associated with z scores for processing speed (beta = –0.003; P = .03) and executive function (beta = –0.003; P = .04) at baseline, but was only inversely associated with change in processing speed (beta = –0.005; P = .03) at follow-up.

“Our data suggest that promoting ideal CV [health] on even a few of these factors may be required to see cognitive health benefits, as participants with only two or three ideal CV [health] factors had less decline over time across multiple domains, particularly processing speed and episodic memory,” the researchers wrote.

A more diverse population should be studied next, and further studies should “identify the age ranges, or period over the life course, during which [CV] health factors and behaviors may be most influential in determining late-life cognitive impairment,” Gardener said in the release.

She also recommended a closer look at “how behavioral and health modifications may influence cognitive performance and mitigate decline over time.” – by Tracey Romero

Disclosure: The study was funded by the Evelyn F. McKnight Brain Institute and the NIH/NINDS. The researchers report no relevant financial disclosures.

More ideal CV health factors are associated with less cognitive decline in older adults, researchers reported in the Journal of the American Heart Association.

Hannah Gardener, Sc D, assistant scientist in neurology at the Miller School of Medicine at University of Miami, and colleagues assessed the CV health of 1,033 participants in the Northern Manhattan Study. The researchers used the American Heart Association’s “Life’s Simple Seven” metric and then measured their memory, executive functioning and brain processing speed with domain-specific z scores at the beginning and end of the study. Of the 1,033 participants, 722 returned for the follow-up cognitive testing approximately 6 years later.

Hannah Gardener

The Life’s Simple Seven definition of CV health includes tobacco avoidance and ideal levels of weight, physical activity, healthy diet, BP, cholesterol and glucose.

Participants in the Northern Manhattan Study were predominately Hispanic (mean age, 72 years). Most participants had achieved two or three ideal CV health factors. Three percent of the participants had no ideal factors, and no participant achieved all seven ideal factors.

Gardener and colleagues observed that participants who had more ideal CV health factors, especially BMI, fasting glucose and nonsmoking status at initial assessment, were more likely to have better brain processing speed at the start of the study and less decline specifically in executive function and episodic memory at follow-up.

In addition, participants with more ideal CV health scores were associated with less decline in the processing speed domain at follow-up, even after adjusting for MRI markers of subclinical vascular damage.

Episodic memory performance and executive function were also affected by the number of ideal CV health factors achieved, but the association was only significant in those who had no cognitive impairment at baseline. No changes were observed in semantic memory performance.

In subsequent sensitivity analyses, systolic BP was inversely associated with z scores for processing speed (beta = –0.003; P = .03) and executive function (beta = –0.003; P = .04) at baseline, but was only inversely associated with change in processing speed (beta = –0.005; P = .03) at follow-up.

“Our data suggest that promoting ideal CV [health] on even a few of these factors may be required to see cognitive health benefits, as participants with only two or three ideal CV [health] factors had less decline over time across multiple domains, particularly processing speed and episodic memory,” the researchers wrote.

A more diverse population should be studied next, and further studies should “identify the age ranges, or period over the life course, during which [CV] health factors and behaviors may be most influential in determining late-life cognitive impairment,” Gardener said in the release.

She also recommended a closer look at “how behavioral and health modifications may influence cognitive performance and mitigate decline over time.” – by Tracey Romero

Disclosure: The study was funded by the Evelyn F. McKnight Brain Institute and the NIH/NINDS. The researchers report no relevant financial disclosures.

    Perspective
    Larry B. Goldstein

    Larry B. Goldstein

    The data are consistent with other studies as discussed by the authors. In addition, a recent report from the Framingham cohort found a decline in dementia over 3 decades that was partially explained by improvement in vascular risk factors. There is increasing evidence indicating that vascular risk factors increase the risk for Alzheimer’s disease in addition to vascular dementia. The shared mechanism is unclear, but one hypothesis is that vascular disease affects the metabolism. Future research should focus on data better elucidating the underlying mechanism and studies evaluating the impact of risk factor modification on cognitive outcomes.

    • Larry B. Goldstein, MD, FAAN, FANA, FAHA
    • Cardiology Today Editorial Board member Ruth L. Works Professor and Chair, Department of Neurology Co-Director, Kentucky Neuroscience Institute Kentucky Clinic, University of Kentucky

    Disclosures: Goldstein reports no relevant financial disclosures.