Hypertension, diabetes, obesity... the impact of cardiovascular risk factors throughout life on cognition in later life

Throughout life, especially in early adulthood, CVRFs are associated with greater cognitive decline in later life.

Currently, nearly 50 million people in the world suffer from dementia.
With the aging of society, it is estimated that by 2050, the number of people with dementia will increase threefold.

At present, there is still no clinically effective treatment for dementia, so prevention is still the key! Many studies have suggested that cardiovascular risk factors (CVRFs) have an important impact on cognition.

A British study published in JAMA Neurol last year reminded that if you don’t pay attention to CVRFs in your 30s, you begin to affect your brain health, and the impact on your heart and brain health at a young age is even greater than that after the age of 50.

Therefore, people are urged to pay attention to cardiovascular health from the early stages of life in order to prevent the occurrence of Alzheimer's more effectively.

At present, little is known about how early adult CVRFs and CVRFs throughout life affect cognitive ability in later life.

In order to test the hypothesis that CVRFs throughout the life of adults are related to cognitive changes in later life, experts from the Neuropsychiatric Center of the University of California in the United States carried out related research, and the results were published in the latest "Neurology" (Neurology) magazine.

The study pooled data from four prospective cohorts (n=15001, age 18-95), and calculated the body mass index (BMI), fasting blood glucose (FG), systolic blood pressure (SBP) and total cholesterol ( TC) trajectory.

A linear mixed model was used to determine the association of early, middle, and late adult CVRFs with declines in overall cognition (modified mini mental status examination (3MS)) and processing speed (digital sign substitution test (DSST)) in later life.

The results showed that the increase in BMI, FG and SBP (but not TC) in each time period was associated with faster cognitive decline in later life.

Among them, the CVRFs in the early years are the most correlated with the magnitude of the decline, with an average decrease of nearly double in 10 years.

CVRFs in later life are associated with cognitive decline in early later life (<80 years).

After adjusting the CVRFs for all time periods, the association between early adult and late adult CVRFs still exists.

Therefore, risk factors such as diabetes, hypertension, middle-aged obesity, lack of physical activity, and smoking are related to both vascular dementia and Alzheimer's disease.

Based on previous articles by experts such as Wang Yongjun, Dean of Beijing Tiantan Hospital affiliated to Capital Medical University, it is suggested that vascular factors are involved in the pathophysiological process of cognitive impairment and dementia, which brings hope to the prevention of dementia by preventing cerebrovascular diseases.

Throughout life, especially in early adulthood, CVRFs are more related to cognitive decline in later life.

The results of this study indicate that CVRFs intervention in early adulthood can benefit cognition in later life, but treatment in very old age may not help these results so much.

 Reference: Yaffe K, et al.
Cardiovascular Risk Factors Across the Life Course and Cognitive Decline: <b>A Pooled Cohort Study.
Neurology.
2021 Mar 17:10.
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