Key result
Premature cardiovascular disease was associated with a 3.07-fold increased odds of accelerated cognitive decline over 5 years compared to individuals without premature CVD.
Why the study?
The role of premature cardiovascular disease (occurring at 60 years or younger) in midlife brain health and cognition was not well understood.
Does premature cardiovascular disease reduce midlife cognition and white matter health in young and middle-aged adults?
Cohort (n=3,146)
Yes
Does premature cardiovascular disease reduce midlife cognition and white matter health in young and middle-aged adults?
Premature cardiovascular disease is associated with worse midlife cognition, accelerated cognitive decline, and poorer white matter health, independent of traditional cardiovascular risk factors.
Answers are grounded in this paper and cite their sources.
May warrant cognitive monitoring in premature CVD; extends midlife associations but remains hypothesis-generating.
BACKGROUND AND OBJECTIVES: To understand the role of premature (defined as ≤ 60 years) cardiovascular disease (CVD) in brain health earlier in life, we examined the associations of premature CVD with midlife cognition and white matter health. METHODS: We studied a prospective cohort in the Coronary Artery Risk Development in Young Adults study, who were 18-30 years at baseline (1985-1986) and followed up to 30 years when 5 cognitive tests measuring different domains were administered. A subset (656 participants) had brain MRI measures of white matter hyperintensity (WMH) and white matter integrity. A premature CVD event was adjudicated based on medical records of coronary heart disease, stroke/TIA, congestive heart failure, carotid artery disease, and peripheral artery disease. We conducted linear regression to determine the associations of nonfatal premature CVD with cognitive performance (z-standardized), cognitive decline, and MRI measures. Premature CVD was associated with greater WMH (total, temporal, and parietal lobes) and higher white matter mean diffusivity (total and temporal lobes) after adjustment for covariates. These associations remained significant after adjusting for cardiovascular risk factors (CVRFs) and excluding those with stroke/TIA. Premature CVD was also associated with accelerated cognitive decline over 5 years (adjusted OR 3.07, 95% CI 1.65-5.71). DISCUSSION: Premature CVD is associated with worse midlife cognition and white matter health, which is not entirely driven by stroke/TIA and even independent of CVRFs. Preventing CVD in early adulthood may delay the onset of cognitive decline and promote brain health over the life course.
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Jiang et al. (2023) conducted a cohort in Premature cardiovascular disease (n=3,146). Premature cardiovascular disease (CVD) vs. No premature CVD was evaluated on Accelerated cognitive decline over 5 years (OR 3.07, 95% CI 1.65-5.71). Premature cardiovascular disease was associated with a 3.07-fold increased odds of accelerated cognitive decline over 5 years compared to individuals without premature CVD.
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