Cognitive decline may be a red flag for future cardiovascular risk
14 giờ trước
Cognitive function deterioration commonly occurs years prior to cardiovascular disease (CVD) events in older adults, as shown in a nested case-control study.
The study involved a prospective cohort of older, community-dwelling adults aged ≥65 years who participated in the Aspirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial and the extension (ASPREE-XT) observational study.
Participants who had a CVD event, including fatal coronary heart disease (CHD), nonfatal myocardial infarction (MI), fatal or nonfatal stroke, and hospitalization for heart failure (HHF), were matched to control participants without a CVD event. Matching was performed based on age, sex, and educational attainment.
Cognitive function was evaluated using the Modified Mini-Mental State Examination, the Hopkins Verbal Learning Test–Revised, the Symbol Digit Modalities Test, and the Controlled Oral Word Association Test.
Over 11 years of follow-up, a total of 1,934 CVD events occurred among 19,114 participants. The analyses included 1,887 case patients and 7,548 matched control participants (n=9,435; overall median age 75.7 years, 52.7 percent male).
Compared with those in the control group, participants in the case group had poorer cognitive function, with the decline occurring between 3 and 8 years before the index CVD event. The case group had faster declines in global cognition (β, −0.19, 95 percent confidence interval [CI], −0.33 to −0.06), episodic memory (β, −0.04, 95 percent CI, −0.11 to −0.03), processing speed (β, −0.28, 95 percent CI, −0.48 to −0.07), and verbal fluency (β, −0.15, 95 percent CI, −0.27 to −0.04) in the years prior to the CVD event.
Similar declines were observed in composite global cognition (β, −0.11, 95 percent CI, −0.17 to −0.06) and executive function scores (β, −0.07, 95 percent CI, −0.11 to −0.03) but not memory in the case vs control group.
The cognitive trajectories observed in the case group were consistent for fatal CHD, stroke, and HHF but not for nonfatal MI.
The findings suggest that cognitive decline may serve as an early indicator of future cardiovascular risk.