Abstract
BackgroundPoor cognitive performance is associated with high vascular risk. However, this association is only investigated in elderly. As neuropathological changes precede clinical symptoms of cognitive impairment by several decades, it is likely that cognitive performance is already associated with vascular risk at middle-age.ObjectivesTo investigate the association of cognitive performance with treatable vascular risk in middle-aged and old persons.DesignLongitudinal study with three measurements during follow-up period of 5.5 years.SettingCity of Groningen, the Netherlands.ParticipantsCohort of 3,572 participants (age range, 35–82 years; mean age, 54 years; men, 52%).ExposureTreatable vascular risk as defined by treatable components of the Framingham Risk Score for Cardiovascular Disease at the first measurement (diabetes mellitus, smoking, hypercholesterolemia and hypertension).MeasurementsChange in cognitive performance during follow-up. Cognitive performance was measured with Ruff Figural Fluency Test (RFFT) and Visual Association Test (VAT), and calculated as the average of the standardized RFFT and VAT score per participant.ResultsThe mean (SD) cognitive performance changed from 0.00 (0.79) at the first measurement to 0.15 (0.83) at second measurement and to 0.39 (0.82) at the third measurement (Ptrend<0.001). This change was negatively associated with treatable vascular risk: the change in cognitive performance between two measurements decreased with 0.004 per one-point increment of treatable vascular risk (95%CI, -0.008 to 0.000; P=0.05) and with 0.006 per one-year increment of age (95%CI, -0.008 to -0.004; P<0.001).ConclusionsChange in cognitive performance was associated with treatable vascular risk in persons aged 35 years or older.
Highlights
Several studies have shown that poor cognitive performance is associated with vascular risk factors in persons aged 60 years or older [1]
Our data suggested that the effect of treatable vascular risk on cognitive performance was comparable to the effect of age
Whereas the other studies included specific populations of elderly people, our study showed this association in population that comprised both middleaged and old persons
Summary
Several studies have shown that poor cognitive performance is associated with vascular risk factors in persons aged 60 years or older [1]. One study included a relatively small sample of 235 men aged 60 years or older [8], whereas the two other studies mainly included even older persons from the same source population (the Alzheimer’s Disease Centers) [9, 10] In these three studies, the treatable vascular risk was based on a stroke-specific risk score and did not include the risk of cardiac or peripheral vascular events [4]. CONCLUSIONS: Change in cognitive performance was associated with treatable vascular risk in persons aged 35 years or older
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