Abstract
BackgroundThe purpose of this prospective cohort study was to examine whether the level of cognitive function at the baseline expressed as a cognitive function composite score and score of specific domains predict the risk of first cardiovascular disease (CVD) events in middle-aged and older populations.MethodsSeven thousand eighty-seven participants, men and women aged 45–72 years, were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006–2008 in the city of Kaunas, Lithuania. During 10 years of follow-up, the risk of first non-fatal events of CVD and death from CVD (excluding those participants with a documented history of CVD and/or ischemic heart disease (IHD) diagnosed at the baseline survey) was evaluated. Cox proportional hazards regression models were applied to examine how cognitive function predicts the first events of CVD.ResultsDuring the follow-up, there were 156 deaths from CVD (49 women and 107 men) and 464 first non-fatal CVD events (195 women and 269 men) registered. The total number of first CVD events was 620 (11.5%). After adjustment for sociodemographic factors, biological and lifestyle risk factors and illnesses, a decrease per 1 standard deviation in different cognitive function scores significantly increased the risk of a first event of CVD (immediate verbal recall score - by 17% in men and 32% in women; delayed verbal recall score – by 17% in men and 24% in women; and a composite score of cognitive function – by 15% in men and 29% in women). Kaplan-Meier survival curves for the probability of a first cardiovascular event according to the categories of a composite score of cognitive function, revealed that a lowered cognitive function predicts a higher probability of the events compared to normal cognitive function (p < 0.05).ConclusionsThe findings of this follow-up study suggest that men and women with lower cognitive functions have an increased risk for a first event of CVD compared to participants with a higher level of cognitive functions.
Highlights
The purpose of this prospective cohort study was to examine whether the level of cognitive function at the baseline expressed as a cognitive function composite score and score of specific domains predict the risk of first cardiovascular disease (CVD) events in middle-aged and older populations
The age-adjusted means of some biologic factors, such as systolic and diastolic blood pressure, triglycerides, the fasting glucose level had been higher and the High-density lipoprotein (HDL) cholesterol level had been lower in men and women who had their first event of CVD compared to those who were alive and without CVD events during the follow-up
It was determined that the respondents who had their first event of CVD at the follow-up had been more often diagnosed with diabetes mellitus, arterial hypertension and obesity at the baseline survey than those who did not have any CVD events
Summary
The purpose of this prospective cohort study was to examine whether the level of cognitive function at the baseline expressed as a cognitive function composite score and score of specific domains predict the risk of first cardiovascular disease (CVD) events in middle-aged and older populations. Several epidemiological studies have demonstrated a relationship between the level of cognitive function and the incidence of some chronic conditions such as hypertension, ischemic heart disease (IHD), diabetes, and stroke [1,2,3,4]. Less is known regarding the link between cognitive function, especially having in mind specific domains of cognitive function, and the incidence of the first event of CVD including both non-fatal and fatal cases of IHD. A small number of epidemiological studies had included the assessment of the risk of first events of CVD according to the level of cognitive function at the baseline [16]
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