The
risk of developing cognitive impairment, especially learning and memory
problems, is significantly greater for people with poor cardiovascular health
than people with intermediate or ideal cardiovascular health, according to a
study in the Journal of the American Heart Association (June 2014)
Cardiovascular
health plays a critical role in brain health, with several cardiovascular risk
factors also playing a role in higher risk for cognitive decline.
Researchers
found that people with the lowest cardiovascular health scores were more likely have impairment on
learning, memory and verbal fluency tests than their counterparts with
intermediate or better risk profiles.
The
study involved 17,761 people aged 45 and older at the outset who had normal
cognitive function and no history of stroke. Mental function was evaluated four
years later.
Researchers
used data from the Reasons for Geographic and Racial Differences in Stroke
(REGARDS) Study to determine cardiovascular health status based on The American
Heart Association Life's Simple 7™ score. The REGARDS study population is 55
percent women, 42 percent blacks, 58 percent whites and 56 percent are
residents of the “stroke belt” states of Alabama, Arkansas, Georgia, Louisiana,
Mississippi, North Carolina, South Carolina and Tennessee.
The
Life’s Simple 7™ initiative is a new system to measure the benefits of
modifiable health behaviors and risk factors in cardiovascular health, such as
smoking, diet, physical activity, body mass index, blood pressure, total
cholesterol, and fasting glucose. It classifies each of the seven factors of
heart health as either poor, intermediate or ideal.
After
accounting for differences in age, sex, race and education, researchers identified
cognitive impairment in:
* 4.6 percent of people
with the worst cardiovascular health scores;
* 2.7 percent of those with
intermediate health profiles; and
* 2.6 percent of those in
the best cardiovascular health category.
“Even
when ideal cardiovascular health is not achieved intermediate levels of
cardiovascular health are preferable to low levels for better cognitive
function,” said lead investigator Evan L. Thacker, Ph.D., an assistant
professor and chronic disease epidemiologist at Brigham Young University
Department of Health Science, in Provo, Utah.
“This
is an encouraging message because intermediate cardiovascular health is a more
realistic target for many individuals than ideal cardiovascular health.”
The
differences were seen regardless of race, gender, pre-existing cardiovascular
conditions, or geographic region, although higher cardiovascular health scores
were more common in men, people with higher education, higher income, and among
people without any cardiovascular disease.
Cognitive
function assessments involved tests to measure verbal learning, memory and
fluency. Verbal learning was determined using a three-trial, ten-item word
list, while verbal memory was assessed by free recall of the ten-item list
after a brief delay filled with non-cognitive questions. Verbal fluency was
determined by asking each participant to name as many animals as possible in 60
seconds.
Although
mechanisms that might explain the findings remain unclear, Thacker said that
undetected subclinical strokes could not be ruled out.
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