Mid-life CV risk tied to early memory problems
March 11th 2011 16:30
Paris, France - Increased cardiovascular risk in midlife is linked to accelerated cognitive decline as early as 10 years later, according to a new analysis from a longitudinal British cohort study [1].
"Most cardiovascular disease risk factors result in progressive changes in blood vessels, including those of the brain," explained lead investigator Sara Kaffashian (French National Institute of Health and Medical Research, Paris, France). "A reduction of blood flow to the brain can cause cerebral damage and lead to cognitive deficits."
The findings were released February 21, 2011 and will be presented in April at the upcoming annual meeting of the American Academy of Neurology in Honolulu, HI.
The study included a sample of 3486 men and 1314 women who were enrolled in the Whitehall II study. At baseline, subjects were a mean age of 55 years and were free of cardiovascular disease (CVD).
In this report, the investigators used the Framingham general cardiovascular risk profile (FGCRP) tool between 1997 and 1999 to predict subjects' risk of having a CVD event. Cognitive function was also assessed at baseline and then again at five and 10 years after study entry.
In sex-specific, cross-sectional, age-adjusted models, they found that each 10% increment in cardiovascular risk was associated with measurable declines in cognitive performance in all cognitive domains from baseline to 10 years in both men and women. For example, each 10% increment in CVD risk was associated with statistically significant drops of 2.8% in memory score for men and a 7.1% drop for women.
In models further adjusted for age, ethnicity, marital status, and education, the 10% increase in CV risk was associated with poorer cognitive performance in all domains except for reasoning in men and fluency in women.
"This is not a subtle cardiovascular effect," commented Dr Richard Lipton (Albert Einstein College of Medicine, Bronx, NY). "Of the common risk factors for CVD, such as hypertension, diabetes, hyperlipidemia, positive family history of early MI or stroke, it takes several to elevate risk to that degree."
The good news is that their data suggest treating hypertension and high cholesterol when patients are in their mid-50s may slow cognitive decline, said Kaffashian.
"When we adjusted the analyses for 'use of antihypertensive medications' during the 10-year follow-up, the association between CVD risk at baseline and 10-year cognitive decline weakened," she said. "Strictly speaking, we cannot talk about improvement of cognitive function—rather, that the decline was slower."
Lipton agreed that it's not clear yet if vascular damage in the brain can ever be "undone."
"Controlling high blood pressure, diabetes, and high cholesterol can reverse atherosclerosis. We can hope for reversal of atherosclerosis or stabilization of cognitive decline, but it is not clear if we can hope for reversal of cognitive decline."
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