TY - JOUR T1 - Cardiovascular Risk Factors Across the Life Course and Cognitive Decline: A Pooled Cohort Study. JF - Neurology Y1 - 2021 A1 - Yaffe, Kristine A1 - Vittinghoff, Eric A1 - Hoang, Tina A1 - Matthews, Karen A1 - Golden, Sherita H A1 - Zeki Al Hazzouri, Adina KW - Adolescent KW - Adult KW - Aged KW - Aged, 80 and over KW - Aging KW - Blood Pressure KW - Cardiovascular Diseases KW - Cognition KW - Cognitive Dysfunction KW - Cohort Studies KW - Female KW - Heart Disease Risk Factors KW - Humans KW - Hypertension KW - Male KW - Middle Aged KW - Risk Factors KW - Young Adult AB -

OBJECTIVE: Cardiovascular risk factors (CVRFs) are associated with increased risk of cognitive decline, but little is known about how early adult CVRFs and those across the life course might influence late-life cognition. To test the hypothesis that CVRFs across the adult life course are associated with late-life cognitive changes, we pooled data from 4 prospective cohorts (n = 15,001, ages 18-95).

METHODS: We imputed trajectories of body mass index (BMI), fasting glucose (FG), systolic blood pressure (SBP), and total cholesterol (TC) for older adults. We used linear mixed models to determine the association of early adult, midlife, and late-life CVRFs with late-life decline on global cognition (Modified Mini-Mental State Examination [3MS]) and processing speed (Digit Symbol Substitution Test [DSST]), adjusting for demographics, education, and cohort.

RESULTS: Elevated BMI, FG, and SBP (but not TC) at each time period were associated with greater late-life decline. Early life CVRFs were associated with the greatest change, an approximate doubling of mean 10-year decline (an additional 3-4 points for 3MS or DSST). Late-life CVRFs were associated with declines in early late life (<80 years) but with gains in very late life (≥80 years). After adjusting for CVRF exposures at all time periods, the associations for early adult and late-life CVRFs persisted.

CONCLUSIONS: We found that imputed CVRFs across the life course, especially in early adulthood, were associated with greater late-life cognitive decline. Our results suggest that CVRF treatment in early adulthood could benefit late-life cognition, but that treatment in very late life may not be as helpful for these outcomes.

VL - 96 IS - 17 ER -