Background:
Accumulating evidence suggests the presence of cardiovascular risk factors in middle-age is associated with later adulthood cognitive dysfunction; however, the consequences of suboptimal cardiovascular health in young adulthood are unclear.
Methods:
The Coronary Artery Risk Development in Young Adults (CARDIA) Study is a cohort of white and black men and women who were 18-30 years when a series of health behaviors (smoking status, body mass index, physical activity, diet) and health factors (total cholesterol, blood pressure, fasting glucose) were measured during a baseline clinic examination in 1985-1986. Included in the current study were 2,577 participants who completed an examination 25 years later when a cognitive battery to assess psychomotor speed (Digit Symbol Substitution Test [DSST]), executive function (modified Stroop Test), and verbal memory (Rey Auditory Verbal Learning Test [RAVLT]) were administered. Ideal levels for each behavior and factor were defined according to the 2020 American Heart Association Goals for Cardiovascular Health. Associations were adjusted for age, sex, race, midlife educational attainment, and study center.
Results:
At baseline, the percentage of participants with 0-1, 2, 3, 4, 5, and 6-7 ideal health factors were 1.2%, 7.2%, 19.6%, 34.9%, 29.2%, and 7.8%, respectively. Adjusted mean DSST and RAVLT scores were higher among those with a greater number of ideal health factors (
Table
). Each additional factor at the ideal level was associated with a 0.78-point higher DSST score (95% CI: 0.28 to 1.28) and a 0.13-point higher memory score (95% CI: 0.02 to 0.25). Results did not differ by race or sex (p-interaction > 0.05). The ideal cardiovascular health score was not associated with performance on the Stroop Test.
Conclusion:
In this population-based sample, ideal cardiovascular health in young adulthood was independently associated with cognitive functioning in midlife.
Table.
Adjusted
*
mean (standard error) cognitive function scores at Year 25 by number of ideal health behaviors and factors at baseline: CARDIA (n=2,577).
No. of Ideal Health Factors at Baseline (% of population)
0-1 (1.2%)
2 (7.2%)
3 (19.6%)
4 (34.9%)
5 (29.2%)
6-7 (7.8%)
p-trend
DSST
70.0 (2.5)
65.7 (1.0)
68.7 (0.6)
69.4 (0.5)
70.0 (0.5)
69.9 (1.0)
0.003
Stroop Test
21.5 (1.6)
21.2 (0.6)
21.0 (0.3)
20.6 (0.3)
20.6 (0.3)
20.4 (0.5)
0.14
RAVLT
7.4 (0.6)
7.6 (0.2)
8.0 (0.1)
8.2 (0.1)
8.3 (0.1)
8.1 (0.2)
0.02
*
Adjusted for age, sex, race, midlife educational attainment, and study center.
DSST=Digit Symbol Substitution Test; RAVLT=Rey Auditory Verbal Learning Test
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