P2-533: IDEAL CARDIOVASCULAR HEALTH AND COGNITIVE PERFORMANCE IN THE BRAZILIAN LONGITUDINAL STUDY OF ADULT HEALTH STUDY (ELSA-BRASIL)

Abstract We investigated cardiovascular health, functional disability and leisure activities profiles independently and in relation to cognitive decline and dementia in high and low-medium income countries using data from the English Longitudinal Study of Ageing, Irish Longitudinal Study on Ageing and Brazilian Bambui Cohort Study of Aging. Functional loss among older Brazilians has shown a hierarchical sequence over the 15-year follow-up, with the highest incidence in functional disability reported for dressing, followed by getting out of bed, bathing/showering, walking across a room, using the toilet and eating (de Oliveira). Using the Life’s Simple 7, an ideal cardiovascular health scoring system evaluating the muscular strength, mobility and physiological stress, we showed a reliable prediction of cognitive trajectories in a representative sample of Irish individuals (De Looze). Within the same cohort, we report discrepancies between men and women in functional decline driven by domestic tasks, rather than determining differential cognitive trajectories (McGarrigle). In an English representative sample, we found that participants with an increasing number of functional impairments over almost a decade were more likely to be classified with subsequent dementia compared with those with no impairments and this may imply a more comprehensive ascertainment during the prodromal stage of dementia (Cadar). In contrast, a reduced risk of dementia was found for individuals with higher levels of engagement in cognitively stimulating activities, that may preserve cognitive reserve until later in life (Almeida). Identifying factors that influence cognitive aging and dementia risk in a multifactorial perspective is critical toward developing adequate intervention and treatment.

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Abstract P196: Insomnia Symptoms And Ideal Cardiovascular Health In Older Women: Data From The Women’S Health Study

Circulation ◽

10.1161/circ.143.suppl_1.p196 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Cameron Hicks ◽

Jonathan Butler ◽

Natalie B Slopen ◽

David Williams ◽

Dayna A Johnson ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Older Women ◽

Sleep Duration ◽

Cardiovascular Health ◽

Health Study ◽

Lower Odds ◽

Ideal Cardiovascular Health ◽

The Relationship ◽

Insomnia Symptoms

Introduction: While insomnia is associated with an increased risk of incident cardiovascular disease (CVD), its relationship with ideal cardiovascular health (ICH) is less certain. Given that sleep disturbances increase with age, we examined the relationship between insomnia symptoms and ICH in older women. Methods: Among women participating in the ongoing Women’s Health Study stress cohort with no apparent history of CVD [N= 2588; Mean age= 72.5 ± 6.3], insomnia symptoms were characterized as self-reported difficulty falling asleep or waking up multiple times a night, three or more times per week. Ideal cardiovascular health, as defined by the American Heart Association’s 2020 Impact goals, included standard optimal targets for blood pressure, total cholesterol, glucose, body mass index, physical activity, diet, and smoking. We examined the relationship between insomnia symptoms and ICH using logistic regression, adjusting for clinical and demographic variables. Results: Of the 26588 participants, 52% reported insomnia symptoms, and 38% had ICH. Women with insomnia symptoms had significantly lower odds of ICH after full adjustment for age, race/ethnicity, education, income, depression/anxiety, marital status, and sleep duration (OR [95% CI]: 0.73 [0.64-0.83]). Moreover, compared to women without insomnia symptoms, those with insomnia symptoms were significantly more likely to have hypertension, diabetes, hypercholesterolemia, depression, anxiety, currently smoke, drink one or more alcoholic beverages per day, have a BMI >30, or exercise less frequently. Conclusion: In older women, insomnia symptoms were significantly associated with lower odds of ideal cardiovascular health even after adjusting for socioeconomic status, psychosocial factors, and sleep duration. These results suggest insomnia screening may be an important component of cardiovascular health promotion in this patient population. Further research is needed to evaluate the effects of sleep behavioral interventions on improving ICH.

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Abstract P113: The Probability of Maintaining Ideal Levels of Glucose in US Populations: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the National Health and Nutrition Examination Survey (NHANES)

Circulation ◽

10.1161/circ.129.suppl_1.p113 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Christy L Avery ◽

Donglin Zeng ◽

Sujatro Chakladar ◽

Katelyn M Holliday ◽

Dan Yu Lin ◽

...

Keyword(s):

Ethnic Groups ◽

Cardiovascular Health ◽

Markov Models ◽

Fasting Glucose ◽

Heart Association ◽

Health Study ◽

Cross Sectional ◽

Ideal Cardiovascular Health ◽

Glucose Levels ◽

Race Ethnicity

Ideal cardiovascular health is a novel concept adopted by the American Heart Association (AHA) that is operationalized through measurement and classification (ideal; intermediate; poor) of seven health metrics, including fasting glucose. Declines in the prevalence of ideal fasting glucose levels have been consistently associated with higher rates of cardiovascular disease, yet few studies have examined the ages at which such declines begin. We used cross-sectional data from NHANES (2007-2010, n=5,961) and the HCHS/SOL (n=14,357) to estimate the age-specific prevalence of ideal (<100 mg/dl without medication), intermediate (100-125 mg/dl or treated to <100 mg/dl) and poor (≥126 mg/dl) fasting glucose levels defined per AHA criteria among European American (EA), African American (AA), and Hispanic/Latino (H/L) participants ≥16 years of age. Race/ethnicity-stratified age-specific net probabilities of transitioning between ideal, intermediate and poor glucose levels were then calculated from cross-sectional estimates using state-of-the-art Markov models that accommodated complex sampling under the assumption that transitions remained stable across time. In all race/ethnic groups, approximately 80% of participants ≤20 years of age had ideal glucose levels. However, the estimated probability of maintaining ideal glucose levels after age 20 varied by race/ethnicity. For example, by the age of 40, the estimated probability of maintaining ideal levels of glucose over the next five years was approximately 90% for EAs and AAs and slightly higher for H/Ls (five-year probability: 92.1%, 95% CI: 91.1%, 93.1%). Among individuals with intermediate glucose levels at age 40, the estimated five-year probability of transitioning to poor levels of glucose was twice as high for AAs (five-year probability: 8.1%, 95% CI: 4.3%, 11.9%) and H/Ls (five-year probability: 9.8%, 95% CI: 8.0%, 11.6%) compared to EAs (five-year probability = 3.9%, 95% CI: 2.7%, 5.3%). Unfortunately, among participants with poor glucose levels, the estimated probability of transitioning to ideal glucose levels remained 0% for all race/ethnic groups and across all ages. Our results suggest that efforts to maintain ideal glucose levels should target young adults and extend through 40 years of age, given the sizeable prevalence of intermediate and poor levels of glucose observed by age 20, the estimated acceleration in the transition to intermediate and poor glucose levels that occurs between the second and fourth decade of life, and the negligible estimated probability of successfully re-attaining ideal glucose levels among those with intermediate or poor glucose levels. Enhanced efforts to identify and treat populations with poor glucose levels also are needed, since these populations would include persons with undiagnosed and therefore untreated type 2 diabetes.

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The Association of Cardiorespiratory Fitness and Ideal Cardiovascular Health in the Aerobics Center Longitudinal Study

Journal of Physical Activity and Health ◽

10.1123/jpah.2018-0220 ◽

2019 ◽

Vol 16 (11) ◽

pp. 968-975

Author(s):

Leanna M. Ross ◽

Jacob L. Barber ◽

Alexander C. McLain ◽

R. Glenn Weaver ◽

Xuemei Sui ◽

...

Keyword(s):

Longitudinal Study ◽

Cardiorespiratory Fitness ◽

Mixed Models ◽

Cardiovascular Health ◽

Cross Sectional ◽

Ideal Cardiovascular Health ◽

The Poor ◽

Longitudinal Associations ◽

Aerobics Center Longitudinal Study

Background: This study examined the cross-sectional and longitudinal associations of cardiorespiratory fitness (CRF) and ideal cardiovascular health (CVH). Methods: CRF and the 7 CVH components were measured in 11,590 (8865 males; 2725 females) adults at baseline and in 2532 (2160 males; 372 females) adults with at least one follow-up examination from the Aerobics Center Longitudinal Study. Ideal CVH score was calculated as a composite of 7 measures, each scored 0 to 2. CVH groups were based on participant point score: ≤7 (poor), 8 to 11 (intermediate), and 12 to 14 (ideal). Analyses included general linear, logistic regression, and linear mixed models. Results: At baseline, participants in the high CRF category had 21% and 45% higher mean CVH scores than those in the moderate and poor CRF categories (P < .001). The adjusted odds (95% confidence interval) of being in the poor CVH group at baseline were 4.9 (4.4–5.4) and 16.9 (14.3–19.9) times greater for individuals with moderate and low CRF, respectively, compared with those with high CRF (P < .001). Longitudinal analysis found that for every 1-minute increase in treadmill time, CVH score increased by 0.23 units (P < .001) independent of age, sex, exam number, and exam year. Conclusions: Higher CRF is associated with better CVH profiles, and improving CRF over time is independently associated with greater improvements in CVH.

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Change in Cardiorespiratory Fitness and Ideal Cardiovascular Health in the Aerobics Center Longitudinal Study

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000519099.39968.5c ◽

2017 ◽

Vol 49 (5S) ◽

pp. 787

Author(s):

Jacob L. Barber ◽

Leanna M. Ross ◽

Xuemei Sui ◽

Steven N. Blair ◽

Mark A. Sarzynski

Keyword(s):

Longitudinal Study ◽

Cardiorespiratory Fitness ◽

Cardiovascular Health ◽

Ideal Cardiovascular Health ◽

Aerobics Center Longitudinal Study

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Financial strain and ideal cardiovascular health in middle-aged and older women: Data from the Women's health study

American Heart Journal ◽

10.1016/j.ahj.2019.06.002 ◽

2019 ◽

Vol 215 ◽

pp. 129-138 ◽

Cited By ~ 2

Author(s):

Tomás Cabeza de Baca ◽

Melissa S. Burroughs Peña ◽

Natalie Slopen ◽

David Williams ◽

Julie Buring ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Older Women ◽

Cardiovascular Health ◽

Financial Strain ◽

Health Study ◽

Middle Aged ◽

Ideal Cardiovascular Health

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Abstract 37: The Association of Cardiorespiratory Fitness and Ideal Cardiovascular Health in the Aerobics Center Longitudinal Study

Circulation ◽

10.1161/circ.135.suppl_1.37 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Leanna M Ross ◽

Jacob L Barber ◽

Xuemei Sui ◽

Steven N Blair ◽

Mark A Sarzynski

Keyword(s):

Longitudinal Study ◽

Cardiorespiratory Fitness ◽

Cardiovascular Health ◽

Smoking Status ◽

Cross Sectional ◽

Ideal Cardiovascular Health ◽

Logistic Regression Models ◽

Using Data ◽

Middle Aged Adults ◽

Aerobics Center Longitudinal Study

Purpose: To examine the cross-sectional association between cardiorespiratory fitness (CRF) and ideal cardiovascular health (CVH) in middle-aged adults. Methods: The association between CRF and ideal CVH score was examined in 11,590 adults (8,865 men, 2,725 women) from the Aerobics Center Longitudinal Study. CRF was measured as duration in minutes from a maximal treadmill test. The AHA’s ideal CVH score was calculated on a 14 point scale using data on smoking status, BMI, physical activity (MET-min/wk), healthy diet, total cholesterol, blood pressure, and fasting plasma glucose recorded between 1987 and 1999. Participants were grouped into categories of inadequate (0-4), average (5-9), and optimum (10-14) based on their CVH score. Three CRF groups were created from age- and sex-specific quintiles based on the previously established cutpoints of treadmill time: low, moderate, and high CRF. We used general linear and logistic regression models adjusted for age, sex, and year of examination to evaluate the association of CRF with ideal CVH score. Results: The mean CVH score for men was 8.4 ± 2.2 and 9.7 ± 2.0 for women. Approximately 33% of men and 57% of women had optimum CVH, while only a small proportion of participants had inadequate CVH (5.1% M, 1.4% F). Treadmill time was moderately correlated (p<0.0001) with CVH score in both men (r=0.56) and women (r=0.50). CRF explained 16% and sex 18% of the variance in CVH score (both p<0.0001). Our adjusted model found that participants in the optimum CVH category had 20% and 43% higher CRF levels than those in the average and inadequate CVH groups (p<0.0001), respectively ( Figure 1 ). The adjusted odds (95% CI) of having optimum CVH were 14.0 (11.0-17.8) and 3.1 (2.4-4.0) times greater for high CRF and moderate CRF, respectively, compared to low CRF (p<0.0001). Discussion: Higher levels of cardiorespiratory fitness are associated with better cardiovascular health profiles in both men and women. Thus, improving fitness represents a strategy to improve cardiovascular and public health.

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Ideal vascular health and cognitive performance in the Brazilian Longitudinal Study of Adult Health

European Journal of Neurology ◽

10.1111/ene.14532 ◽

2020 ◽

Vol 28 (1) ◽

pp. 71-80

Author(s):

C. K. Suemoto ◽

C. Szlejf ◽

I.S. Santos ◽

A. R. Brunoni ◽

A.C. Goulart ◽

...

Keyword(s):

Longitudinal Study ◽

Cognitive Performance ◽

Vascular Health ◽

Adult Health

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EARLY FRAILTY PHENOTYPES AND PREDICTIONS OF COGNITIVE AGING: EVIDENCE FROM THE VICTORIA LONGITUDINAL STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.1077 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S292-S293

Author(s):

Linzy Bohn ◽

Yao Zheng ◽

G Peggy McFall ◽

Roger A Dixon

Keyword(s):

Longitudinal Study ◽

Cognitive Performance ◽

Cognitive Aging ◽

Latent Variables ◽

Latent Profile Analysis ◽

Cardiovascular Health ◽

Profile Analysis ◽

Community Dwelling ◽

Data Driven ◽

Data Driven Approach

Abstract Frailty is an aging condition that reflects multisystem decline. A prominent approach to frailty assessment is to create an index, whereby responses across multiple indicators of aging systems are summed to create a single score. These studies indicate that frailty is associated with adverse aging outcomes (e.g., mortality, dementia). We employ a data-driven approach to detecting and differentiating emerging frailty phenotypes and examine their associations with non-demented cognitive aging trajectories. Participants (n = 653; M age = 70.6, range 53-95) were community-dwelling older adults from the Victoria Longitudinal Study. Participants contributed (a) baseline data for 30 frailty-related items representing deficits across 7 domains (e.g., instrumental and cardiovascular health) and (b) longitudinal data for latent variables of executive function, speed, and memory. For each participant, we calculated the proportion of deficits present in each frailty-related domain and submitted these data to a latent profile analysis (LPA; Mplus 7.0). We used latent growth modeling (LGM) to test these frailty phenotypes for prediction of cognitive performance and decline. LPA results revealed three profiles, one large normal low-frailty profile and two emerging frailty phenotypes. Whereas the latter represented profiles of individuals with respiratory-type frailty (i.e., marked impairment in respiratory function; 7%) and mobility-type frailty (i.e., marked impairment in mobility function; 9%), the former featured limited impairment across frailty domains (83%). Findings from LGM indicated that these profiles were differentially related to cognitive performance and decline. Data-driven approaches can help detect early differentiation of frailty profiles and contribute to personalized intervention.

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