Abstract P019: Family History of Cardiovascular Disease is Associated With Cognitive Function: The Emory Healthy Aging Study

Abstract

Background: Family history of cardiovascular disease (CVD) is a readily available risk indicator of future CVD, combining the influence of shared genetic, environmental and behavioral risk factors. Though CVD risk factors have been associated with an increased risk of cognitive impairment and decline, less is known about the association between family history of CVD and cognitive function. Evaluating this association may further elucidate the role of cardiovascular health in cognitive health. Methods: The Emory Healthy Aging Study isan ongoing prospective cohort study aimed at identifying predictors of healthy aging and age-related diseases. Participants are primarily residents of the Atlanta area, at least 18 years old, who completed an online baseline health survey. Multiple recruitment forums were used, including clinic waiting rooms, informational letters and emails, community events and online recruitment. Baseline information about demographic (age, race, gender), socioeconomic (education, household income), and health behavior factors (physical activity, smoking) as well as personal health (diabetes, hyperlipidemia, and hypertension) and family health history were collected by online survey. Family history of CVD was defined as self-reported history for any parent or sibling of coronary artery disease, myocardial infarction, or stroke. Cognitive function was measured using the validated Cognitive Function Instrument (CFI) with scores ranging between 0-14 (lower is better). The association between family history of CVD and CFI score was assessed using multivariable linear regression, adjusting for demographic, socioeconomic, lifestyle and CVD risk factors, as well as family history of mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Results: We studied 3801 participants (75% female, 85% white, 10% black, and 5% other), recruited between October 2015 and October 2016. Mean age was 59±13 years and 61% reported a family history of CVD. Adjusting for age, gender, race, education, household income, exercise habits, smoking status and family history of MCI or AD, family history of CVD was associated with poorer cognitive performance (β=0.26; 95% CI (0.12, 0.41)). Additional adjustment for hypertension, hyperlipidemia, diabetes and BMI only slightly attenuated estimates (β=0.22; 95% CI (0.08, 0.41)). In the same model, the estimated β for family history of cognitive impairment was similar: 0.22 (0.07, 0.37). Conclusion: In this cross-sectional study of people from the community, family history of CVD was associated with poorer cognitive function, and this association was of the same magnitude as having a first-degree family member with a history of cognitive impairment. Although longitudinal data are needed, these results underscore the link between cardiovascular and neurocognitive health and potential role of shared genetic and behavioral factors.