Relationship between Life’s essential 8 scores and cognitive decline in the ELSA‐Brasil cohort

Abstract

AbstractBackgroundLifestyle and cardiovascular risk factors were combined in the Life’s simple 7 (LS7) index to evaluate cardiovascular health, and this index has been previously associated with cognitive decline. The Life’s Essential 8 (LE8) is an update of LS7, which now includes sleep health as an additional factor. We aimed to verify the association between LE8 and cognitive decline during X years of follow‐up in 11,390 participants from a racially diverse sample.MethodIn this cohort study, LE8 score was measured based on diet, physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure. Cognition was assessed in three waves four years apart from each other using the CERAD word list, semantic and phonemic verbal fluency, Trail Making Test B (TMT‐B), and a global composite score. We used inverse probability weighting to account for mortality and attrition bias and linear mixed models with random intercepts and slopes to verify the association between baseline LE8 score and cognitive decline. We tested the interaction between LE8 and age, sex, and race.ResultThe mean sample age was 51.4±8.9yo at baseline, 56% were women, and 43% Black. Higher baseline LE8 scores were associated with slower memory (β = 0.001; 95%CI = 0.000,0.002; p = 0.013), verbal fluency (β = 0.001; 95%CI = 0.000,0.002; p = 0.003), executive function (β = 0.004; 95%CI = 0.003,0.005; p<0.001), and global cognitive decline (β = 0.001; 95%CI = 0.001,0.002; p<0.001) (Table 1). Age (p < 0.001), sex (p < 0.001), and race (p < 0.001) were modifiers of the association between LE8 score and global cognitive decline (Figure 1), suggesting that in different socioeconomic profiles, this association might have different manifestations.ConclusionHigher baseline LE8 scores were associated with global and domain‐specific decline after eight years of follow‐up. Age, sex, and race were modifiers of this association, suggesting that it might differ based on the participant’s socioeconomic profile.