Beyond the SCORE2: unveiling the hidden links between cardiovascular risk and cognition, health literacy, quality-of-life in dyslipidemia

Abstract Introduction The SCORE2 algorithm provides a refined estimation of 10-year cardiovascular risk in European populations, integrating lipid parameters as key predictors. Dyslipidemia, as a modifiable cardiovascular risk factor, has been linked not only to increased cardiovascular morbidity but also to impaired quality of life, cognitive decline, and limited health literacy. Exploring these interrelations may enhance risk stratification and support more holistic preventive strategies in cardiopulmonary rehabilitation settings. Methods Sixty-two patients with dyslipidemia included in this study. Patients’ cardiovascular risk calculated according to SCORE2 algorithm. Patients’ quality-of-life evaluated with 36-Item Short Form Health Survey questionnaire (SF-36), health literacy with European Health Literacy Survey Questionnaire (HLS-EU-Q47) and cognitive health with Mini Mental State Examination (MMSE). Results Mean SCORE2 of participants was 3.58±0.47 points. SCORE2 has significant negative correlations between total score (r:-0.342, p:0.007), healthcare score (r:-0.425, p:0.001) and disease prevention score (r:-0.303, p:0.019) of HLS-EU-Q47; MMSE score (r:-0.517, p0.001) and social function score (r:-0.321, p:0.018) of SF-36. On the other hand, suprisingly, SCORE2 has significant positive correlations between vitality score (r:0.342, p:0.011) and emotional role limitation score (r:0.270, p:0.049) of SF-36. Discussion: The mean SCORE2 value reflects a moderate cardiovascular risk profile among participants, yet its multidimensional correlations reveal deeper implications. The negative associations between SCORE2 and health literacy suggest that individuals with higher cardiovascular risk may struggle to engage effectively with health care and preventive health attitudes. Moreover, the strong inverse correlation with MMSE scores highlights a concerning link between elevated cardiovascular risk and cognitive decline, in vascular–cognitive axis. The reduction in social functioning underscores the psychosocial burden of cardiovascular diseases. Interestingly, the positive correlations with vitality and emotional role limitation scores may reflect a paradoxical resilience or compensatory adaptation in individuals. This unexpected finding warrants further exploration into psychological coping mechanisms and perceived health in dyslipidemic populations. Conclusions SCORE2 is not only a cardiovascular risk estimator—it appears to intersect meaningfully with cognitive health, quality-of-life, and health literacy. These findings promote for a more integrative approach to risk assessment in cardiopulmonary rehabilitation, one that considers not only lipid profiles but also the cognitive and health literacy dimensions of patient care. Future studies should explore whether enhancing health literacy and cognitive support can modulate cardiovascular risk in at-risk populations.