Early adult to midlife cardiovascular risk factors and cognitive function

Kristine Yaffe, Eric Vittinghoff, Mark J. Pletcher, Tina D. Hoang, Lenore J. Launer, Rachel Whitmer, Laura H. Coker, Stephen Sidney

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Background: Studies have linked midlife and late-life cardiovascular risk factors (CVRFs) to cognitive function, yet little is known about CVRF exposure in early adulthood and subsequent cognitive function. In addition, most studies rely on single assessments of CVRFs, which may not accurately reflect long-term exposure. We sought to determine the association between cumulative exposure to CVRFs from early to middle adulthood and cognitive function at midlife. Methods and results: In a prospective study of 3381 adults (age, 18-30 years at baseline) with 25 years of follow-up, we assessed cognitive function at year 25 (2010-2011) with the Digit Symbol Substitution Test, Stroop Test, and Rey Auditory Verbal Learning Test analyzed with standardized z scores. The primary predictor was 25-year cumulative exposure estimated by areas under the curve for resting systolic and diastolic blood pressures, fasting blood glucose, and total cholesterol. Higher cumulative systolic and diastolic blood pressures and fasting blood glucose were consistently associated with worse cognition on all 3 tests. These associations were significant primarily for exposures above recommended guidelines; cognitive test z scores were between 0.06 and 0.30 points less, on average, for each 1-SD increase in risk factor area under the curve after adjustment for age, race, sex, and education (P<0.05 for all). Fewer significant associations were observed for cholesterol. Conclusions: Cumulative exposure to CVRFs from early to middle adulthood, especially above recommended guidelines, was associated with worse cognition in midlife. The meaning of this association and whether it warrants more aggressive treatment of CVRFs earlier in life require further investigation.

Original languageEnglish (US)
Pages (from-to)1560-1567
Number of pages8
JournalCirculation
Volume129
Issue number15
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Cognition
Blood Pressure
Area Under Curve
Blood Glucose
Fasting
Cholesterol
Guidelines
Stroop Test
Verbal Learning
Sex Education
Prospective Studies

Keywords

  • blood pressure
  • cholesterol
  • cognition
  • glucose
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Yaffe, K., Vittinghoff, E., Pletcher, M. J., Hoang, T. D., Launer, L. J., Whitmer, R., ... Sidney, S. (2014). Early adult to midlife cardiovascular risk factors and cognitive function. Circulation, 129(15), 1560-1567. https://doi.org/10.1161/CIRCULATIONAHA.113.004798

Early adult to midlife cardiovascular risk factors and cognitive function. / Yaffe, Kristine; Vittinghoff, Eric; Pletcher, Mark J.; Hoang, Tina D.; Launer, Lenore J.; Whitmer, Rachel; Coker, Laura H.; Sidney, Stephen.

In: Circulation, Vol. 129, No. 15, 01.01.2014, p. 1560-1567.

Research output: Contribution to journalArticle

Yaffe, K, Vittinghoff, E, Pletcher, MJ, Hoang, TD, Launer, LJ, Whitmer, R, Coker, LH & Sidney, S 2014, 'Early adult to midlife cardiovascular risk factors and cognitive function', Circulation, vol. 129, no. 15, pp. 1560-1567. https://doi.org/10.1161/CIRCULATIONAHA.113.004798
Yaffe K, Vittinghoff E, Pletcher MJ, Hoang TD, Launer LJ, Whitmer R et al. Early adult to midlife cardiovascular risk factors and cognitive function. Circulation. 2014 Jan 1;129(15):1560-1567. https://doi.org/10.1161/CIRCULATIONAHA.113.004798
Yaffe, Kristine ; Vittinghoff, Eric ; Pletcher, Mark J. ; Hoang, Tina D. ; Launer, Lenore J. ; Whitmer, Rachel ; Coker, Laura H. ; Sidney, Stephen. / Early adult to midlife cardiovascular risk factors and cognitive function. In: Circulation. 2014 ; Vol. 129, No. 15. pp. 1560-1567.
@article{79da95feab4744fb81bca8eb63d98e19,
title = "Early adult to midlife cardiovascular risk factors and cognitive function",
abstract = "Background: Studies have linked midlife and late-life cardiovascular risk factors (CVRFs) to cognitive function, yet little is known about CVRF exposure in early adulthood and subsequent cognitive function. In addition, most studies rely on single assessments of CVRFs, which may not accurately reflect long-term exposure. We sought to determine the association between cumulative exposure to CVRFs from early to middle adulthood and cognitive function at midlife. Methods and results: In a prospective study of 3381 adults (age, 18-30 years at baseline) with 25 years of follow-up, we assessed cognitive function at year 25 (2010-2011) with the Digit Symbol Substitution Test, Stroop Test, and Rey Auditory Verbal Learning Test analyzed with standardized z scores. The primary predictor was 25-year cumulative exposure estimated by areas under the curve for resting systolic and diastolic blood pressures, fasting blood glucose, and total cholesterol. Higher cumulative systolic and diastolic blood pressures and fasting blood glucose were consistently associated with worse cognition on all 3 tests. These associations were significant primarily for exposures above recommended guidelines; cognitive test z scores were between 0.06 and 0.30 points less, on average, for each 1-SD increase in risk factor area under the curve after adjustment for age, race, sex, and education (P<0.05 for all). Fewer significant associations were observed for cholesterol. Conclusions: Cumulative exposure to CVRFs from early to middle adulthood, especially above recommended guidelines, was associated with worse cognition in midlife. The meaning of this association and whether it warrants more aggressive treatment of CVRFs earlier in life require further investigation.",
keywords = "blood pressure, cholesterol, cognition, glucose, risk factors",
author = "Kristine Yaffe and Eric Vittinghoff and Pletcher, {Mark J.} and Hoang, {Tina D.} and Launer, {Lenore J.} and Rachel Whitmer and Coker, {Laura H.} and Stephen Sidney",
year = "2014",
month = "1",
day = "1",
doi = "10.1161/CIRCULATIONAHA.113.004798",
language = "English (US)",
volume = "129",
pages = "1560--1567",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "15",

}

TY - JOUR

T1 - Early adult to midlife cardiovascular risk factors and cognitive function

AU - Yaffe, Kristine

AU - Vittinghoff, Eric

AU - Pletcher, Mark J.

AU - Hoang, Tina D.

AU - Launer, Lenore J.

AU - Whitmer, Rachel

AU - Coker, Laura H.

AU - Sidney, Stephen

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Studies have linked midlife and late-life cardiovascular risk factors (CVRFs) to cognitive function, yet little is known about CVRF exposure in early adulthood and subsequent cognitive function. In addition, most studies rely on single assessments of CVRFs, which may not accurately reflect long-term exposure. We sought to determine the association between cumulative exposure to CVRFs from early to middle adulthood and cognitive function at midlife. Methods and results: In a prospective study of 3381 adults (age, 18-30 years at baseline) with 25 years of follow-up, we assessed cognitive function at year 25 (2010-2011) with the Digit Symbol Substitution Test, Stroop Test, and Rey Auditory Verbal Learning Test analyzed with standardized z scores. The primary predictor was 25-year cumulative exposure estimated by areas under the curve for resting systolic and diastolic blood pressures, fasting blood glucose, and total cholesterol. Higher cumulative systolic and diastolic blood pressures and fasting blood glucose were consistently associated with worse cognition on all 3 tests. These associations were significant primarily for exposures above recommended guidelines; cognitive test z scores were between 0.06 and 0.30 points less, on average, for each 1-SD increase in risk factor area under the curve after adjustment for age, race, sex, and education (P<0.05 for all). Fewer significant associations were observed for cholesterol. Conclusions: Cumulative exposure to CVRFs from early to middle adulthood, especially above recommended guidelines, was associated with worse cognition in midlife. The meaning of this association and whether it warrants more aggressive treatment of CVRFs earlier in life require further investigation.

AB - Background: Studies have linked midlife and late-life cardiovascular risk factors (CVRFs) to cognitive function, yet little is known about CVRF exposure in early adulthood and subsequent cognitive function. In addition, most studies rely on single assessments of CVRFs, which may not accurately reflect long-term exposure. We sought to determine the association between cumulative exposure to CVRFs from early to middle adulthood and cognitive function at midlife. Methods and results: In a prospective study of 3381 adults (age, 18-30 years at baseline) with 25 years of follow-up, we assessed cognitive function at year 25 (2010-2011) with the Digit Symbol Substitution Test, Stroop Test, and Rey Auditory Verbal Learning Test analyzed with standardized z scores. The primary predictor was 25-year cumulative exposure estimated by areas under the curve for resting systolic and diastolic blood pressures, fasting blood glucose, and total cholesterol. Higher cumulative systolic and diastolic blood pressures and fasting blood glucose were consistently associated with worse cognition on all 3 tests. These associations were significant primarily for exposures above recommended guidelines; cognitive test z scores were between 0.06 and 0.30 points less, on average, for each 1-SD increase in risk factor area under the curve after adjustment for age, race, sex, and education (P<0.05 for all). Fewer significant associations were observed for cholesterol. Conclusions: Cumulative exposure to CVRFs from early to middle adulthood, especially above recommended guidelines, was associated with worse cognition in midlife. The meaning of this association and whether it warrants more aggressive treatment of CVRFs earlier in life require further investigation.

KW - blood pressure

KW - cholesterol

KW - cognition

KW - glucose

KW - risk factors

UR - http://www.scopus.com/inward/record.url?scp=84899108433&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899108433&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.113.004798

DO - 10.1161/CIRCULATIONAHA.113.004798

M3 - Article

C2 - 24687777

AN - SCOPUS:84899108433

VL - 129

SP - 1560

EP - 1567

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 15

ER -