Abstract MP28: Life’s Simple 7 and Incident Cognitive Impairment: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Abstract

HYPOTHESIS. We hypothesized that higher scores on Life’s Simple 7 (LS7), a composite measure of cardiovascular health, are associated with lower incidence of cognitive impairment in the absence of stroke, and that this association differs by race and geographic region. METHODS. We included REGARDS participants aged 45+ who at baseline were cognitively normal by the Six-Item Screener (SIS) and free of stroke. We censored participants at incident stroke. We calculated baseline LS7 score, ranging from 0 points (worst) to 14 points (best), from smoking, BMI, physical activity, diet, cholesterol, blood pressure, and fasting glucose. We defined incident cognitive impairment as (1) scoring ≤4 of 6 points on the most recent follow-up SIS, or (2) scoring ≥1.5 standard deviations below age, sex, race, and education-adjusted means on the most recent of at least 2 of 3 domain-specific cognitive tests. We calculated age, sex, race, and education-standardized percentages of participants with incident impairment by LS7 score tertiles, and age, sex, race, education, and region-adjusted odds ratios by tertiles and per 1 point higher LS7 score. We repeated analyses by race (black/white) and region (southeastern US stroke belt/nonbelt). RESULTS. The distribution of LS7 scores was higher in whites than blacks and outside the stroke belt than within the stroke belt. Incidence of cognitive impairment was lower at higher LS7 scores (Table). This inverse association was stronger for cognitive domain testing than for SIS. For SIS, we observed an inverse association among whites and outside the stroke belt, but not among blacks or within the stroke belt. For cognitive domain testing, the inverse association was similar across race and region. CONCLUSIONS. Favorable LS7 scores are associated with lower incidence of cognitive impairment, particularly as assessed by cognitive domain testing. Racial and regional differences in cardiovascular health and its association with cognitive impairment may contribute to cognitive impairment disparities.