- Email: [email protected]
Cardiovascular risk factors for cognitive function: Effects from early adulthood to mid-life
Oral Sessions: O1-05: Public Health and Psychosocial Focus: Epidemiology I—Cardiovascular Risks and Blood Institute, Bethesda, Maryland, United States; 7National Institute on Aging, Bethesda, Maryland, United States. Contact e-mail: tina.hoang@ va.gov Background: Few studies have investigated whether physical activity in early to mid-life is associated with cognitive function even though this may be a critical period for establishing life-long activity habits. We investigated the relationship between long-term patterns of low physical activity over 25 years with cognitive function in mid-life. Methods: In a biracial cohort of 3,375 adults, (ages 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-86) and followed for 25 years, physical activity was assessed at repeated visits (3 assessments) using a validated physical activity questionnaire and cognitive function was evaluated at the end of follow-up, Year 25. A long-term pattern of low physical activity over 25 years was defined as reporting activity levels within the bottom tertile (<247 exercise units) of baseline physical activity scores for >2/3 rds of completed visits. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST, standard deviation (SD)¼16.16), Stroop Interference Score (SD¼10.98), and Rey Auditory Verbal Learning Test (RAVLT, SD¼3.27). Results: 26% of participants reported a long-term pattern of low physical activity over 25 years. Compared to more active participants, long-term patterns of low physical activity were associated with increased likelihood of significant poor cognitive performance (<1 SD below the mean) on DSST (inactive: 19% vs active: 15%, OR¼1.67, 95% CI 1.30-2.13) and Stroop (inactive: 18% vs active: 11%, OR¼1.47, 95% CI 1.15-1.88) but not on RAVLT, after adjusting for age, race, sex, education, smoking, body mass index, and hypertension. For those with very-low activity patterns (long-term pattern of physical activity scores <50 exercise units, 2% of participants), effects were even more pronounced (DSST: OR¼2.52, 95% CI 1.34-4.75; Stroop: OR¼2.24, 95% CI 1.21-4.14). Conclusions: Beginning in early adulthood, long-term patterns of low physical activity over 25 years were associated with worse mid-life executive function and processing speed. Future prevention strategies should focus on increasing physical activity across the life course. O1-05-02
CARDIOVASCULAR RISK FACTORS FOR COGNITIVE FUNCTION: EFFECTS FROM EARLY ADULTHOOD TO MID-LIFE
Kristine Yaffe1, Eric Vittinghoff1, Mark Pletcher1, Tina Hoang2, Lenore Launer3, Rachel Whitmer4, Laura5, Steve Sidney6, 1University of California, San Francisco, San Francisco, California, United States; 2 NCIRE, San Francisco, California, United States; 3National Institute on Aging, Bethesda, Maryland, United States; 4Kaiser Permanente Division of Research, Oakland, California, United States; 5Wake Forest School of Medicine, Winston-Salem, North Carolina, United States; 6Kaiser Permanente Northern California, Oakland, California, United States. Contact e-mail: [email protected] Background: Most studies investigating the relationship between cardiovascular risk factors (CVRFs) and cognitive function have focused on mid to late-life exposures, but little is known about this association starting from early adulthood and few have considered the cumulative effects of individual CVRFs over time. We investigated the relationship between cumulative burden of CVRFs from early to middle adulthood and cognitive function. Methods: In a prospective, biracial cohort of 3,498 adults, ages 18 to 30, enrolled in the CARDIA Study and followed for 25 years, cumulative exposure to fasting blood glucose, triglycerides, low and high density lipoproteins (LDL and HDL), and resting systolic and diastolic blood pressure (SBP and DBP) were estimated by areas under the curve (AUCs). Cognitive function at the Year 25 visit was assessed with the Digit Symbol Substitution Test (DSST), the Stroop Test, and Rey Auditory Verbal Learning Test (RAVLT) and analyzed with standardized z scores. Results: At Year 25, participant mean age was 50.2 (SD¼3.6), 46.9% were Black, and 43.4% were male. We found consistent associations for glucose, SBP, DBP, and triglycerides for all cognitive test domains after
P135
adjusting for age, race, gender, education, diabetes, smoking, and body mass index. For example, cognitive test z scores were between 0.08 and 0.10 points less for each standard deviation (SD) of glucose AUC, between 0.07 and 0.10 points less for SBP, between 0.06 and 0.07 points less for DBP, and between 0.04 and 0.05 points less for each SD of triglyceride AUC; p<0.05 for all. Few significant associations were observed for the cumulative effects of LDL or HDL. For most CVRFs, there was an association with cognitive function for both early (age<35) and middle adulthood (age>35) but the magnitude of the effects was small. Conclusions: Cumulative exposure of CVRFs from early to middle adulthood was associated with worse cognitive function in mid-life. Treatment of cardiovascular risk factors in early and mid-life and its effects on cognitive function need to be investigated.
O1-05-03
ACCORDANCE TO DIETARY APPROACHES TO STOP HYPERTENSION (DASH) IS ASSOCIATED WITH SLOWER COGNITIVE DECLINE
Christy Tangney1, Hong Li2, Lisa L. Barnes2, Julie Schneider3, David Bennett2, Martha Morris2, 1Rush University Medical Center, Arlington Heights, Illinois, United States; 2Rush University Medical Center, Chicago, Illinois, United States; 3Rush University Medical Center, Rush Alzheimer’s Disease Center, Chicago, Illinois, United States. Contact e-mail: [email protected] Background: The DASH (Dietary Approach to Stop Hypertension) diet has been shown to be protective against hypertension and diabetes, conditions that have also been shown to increase cognitive decline. The DASH diet is characterized by high consumption of fruits, vegetables, whole grains, nuts/seeds/legumes, lean meats/fish/poultry, lowor non-fat dairy and low consumption of sweets and of sodium. We examined whether accordance to a DASH plan is associated with slower cognitive decline in a prospective cohort study of persons 65 years and older. Methods: The sample was comprised of participants of the Memory and Aging Project (MAP) who agreed to complete a 144-item food frequency questionnaire (FFQ) (80% of surviving participants). A summary score (0-10) of accordance to the DASH diet was computed based on the assessment of the 8 dietary components above plus % energy from total fat and from saturated fat. A higher score reflects perfect DASH accordance. In annual neurological examinations, MAP participants’ global cognitive function was assessed with a battery of 19 cognitive tests. Global cognitive scores were computed by averaging the z-scores of the individual tests. Analyses were performed on a sample of 823 participants who completed a FFQ and had undergone 2 or more cognitive assessments. The median time of follow-up was 4 years. Results: The mean global cognitive score at baseline was 0.14 (range: -3.24 to 1.61), and the overall mean change in score per year was a decline of -0.08 standardized units. The mean DASH score was 4.0 6 1.3 with a range from 1.5 to 8.5. In mixed models adjusted for age, sex, race, and education, the DASH diet score was positively associated with slower rate of cognitive decline. Per 1-unit change in DASH score the decline rate was slower by 0.010 standardized units (SE¼0.004; p¼0.006). Conclusions: These data support the hypothesis that the DASH diet characterized by high consumption of vegetables, fruits, whole grains, lean meats, poultry and fish and low in sweets and sodium is associated with a slower rate of cognitive decline in older persons.
O1-05-04
REDUCED HEART RATE VARIABILITY IS ASSOCIATED WITH WORSE COGNITIVE FUNCTION IN ELDERLY MEXICAN-AMERICANS
Adina Zeki Al Hazzouri, Mary Haan, University of California San Francisco, San Francisco, California, United States. Contact e-mail: adina. [email protected]
CARDIOVASCULAR RISK FACTORS FOR COGNITIVE FUNCTION: EFFECTS FROM EARLY ADULTHOOD TO MID-LIFE
Kristine Yaffe1, Eric Vittinghoff1, Mark Pletcher1, Tina Hoang2, Lenore Launer3, Rachel Whitmer4, Laura5, Steve Sidney6, 1University of California, San Francisco, San Francisco, California, United States; 2 NCIRE, San Francisco, California, United States; 3National Institute on Aging, Bethesda, Maryland, United States; 4Kaiser Permanente Division of Research, Oakland, California, United States; 5Wake Forest School of Medicine, Winston-Salem, North Carolina, United States; 6Kaiser Permanente Northern California, Oakland, California, United States. Contact e-mail: [email protected] Background: Most studies investigating the relationship between cardiovascular risk factors (CVRFs) and cognitive function have focused on mid to late-life exposures, but little is known about this association starting from early adulthood and few have considered the cumulative effects of individual CVRFs over time. We investigated the relationship between cumulative burden of CVRFs from early to middle adulthood and cognitive function. Methods: In a prospective, biracial cohort of 3,498 adults, ages 18 to 30, enrolled in the CARDIA Study and followed for 25 years, cumulative exposure to fasting blood glucose, triglycerides, low and high density lipoproteins (LDL and HDL), and resting systolic and diastolic blood pressure (SBP and DBP) were estimated by areas under the curve (AUCs). Cognitive function at the Year 25 visit was assessed with the Digit Symbol Substitution Test (DSST), the Stroop Test, and Rey Auditory Verbal Learning Test (RAVLT) and analyzed with standardized z scores. Results: At Year 25, participant mean age was 50.2 (SD¼3.6), 46.9% were Black, and 43.4% were male. We found consistent associations for glucose, SBP, DBP, and triglycerides for all cognitive test domains after
P135
adjusting for age, race, gender, education, diabetes, smoking, and body mass index. For example, cognitive test z scores were between 0.08 and 0.10 points less for each standard deviation (SD) of glucose AUC, between 0.07 and 0.10 points less for SBP, between 0.06 and 0.07 points less for DBP, and between 0.04 and 0.05 points less for each SD of triglyceride AUC; p<0.05 for all. Few significant associations were observed for the cumulative effects of LDL or HDL. For most CVRFs, there was an association with cognitive function for both early (age<35) and middle adulthood (age>35) but the magnitude of the effects was small. Conclusions: Cumulative exposure of CVRFs from early to middle adulthood was associated with worse cognitive function in mid-life. Treatment of cardiovascular risk factors in early and mid-life and its effects on cognitive function need to be investigated.
O1-05-03
ACCORDANCE TO DIETARY APPROACHES TO STOP HYPERTENSION (DASH) IS ASSOCIATED WITH SLOWER COGNITIVE DECLINE
Christy Tangney1, Hong Li2, Lisa L. Barnes2, Julie Schneider3, David Bennett2, Martha Morris2, 1Rush University Medical Center, Arlington Heights, Illinois, United States; 2Rush University Medical Center, Chicago, Illinois, United States; 3Rush University Medical Center, Rush Alzheimer’s Disease Center, Chicago, Illinois, United States. Contact e-mail: [email protected] Background: The DASH (Dietary Approach to Stop Hypertension) diet has been shown to be protective against hypertension and diabetes, conditions that have also been shown to increase cognitive decline. The DASH diet is characterized by high consumption of fruits, vegetables, whole grains, nuts/seeds/legumes, lean meats/fish/poultry, lowor non-fat dairy and low consumption of sweets and of sodium. We examined whether accordance to a DASH plan is associated with slower cognitive decline in a prospective cohort study of persons 65 years and older. Methods: The sample was comprised of participants of the Memory and Aging Project (MAP) who agreed to complete a 144-item food frequency questionnaire (FFQ) (80% of surviving participants). A summary score (0-10) of accordance to the DASH diet was computed based on the assessment of the 8 dietary components above plus % energy from total fat and from saturated fat. A higher score reflects perfect DASH accordance. In annual neurological examinations, MAP participants’ global cognitive function was assessed with a battery of 19 cognitive tests. Global cognitive scores were computed by averaging the z-scores of the individual tests. Analyses were performed on a sample of 823 participants who completed a FFQ and had undergone 2 or more cognitive assessments. The median time of follow-up was 4 years. Results: The mean global cognitive score at baseline was 0.14 (range: -3.24 to 1.61), and the overall mean change in score per year was a decline of -0.08 standardized units. The mean DASH score was 4.0 6 1.3 with a range from 1.5 to 8.5. In mixed models adjusted for age, sex, race, and education, the DASH diet score was positively associated with slower rate of cognitive decline. Per 1-unit change in DASH score the decline rate was slower by 0.010 standardized units (SE¼0.004; p¼0.006). Conclusions: These data support the hypothesis that the DASH diet characterized by high consumption of vegetables, fruits, whole grains, lean meats, poultry and fish and low in sweets and sodium is associated with a slower rate of cognitive decline in older persons.
O1-05-04
REDUCED HEART RATE VARIABILITY IS ASSOCIATED WITH WORSE COGNITIVE FUNCTION IN ELDERLY MEXICAN-AMERICANS
Adina Zeki Al Hazzouri, Mary Haan, University of California San Francisco, San Francisco, California, United States. Contact e-mail: adina. [email protected]