Cited by 308Dementia and Cognitive Impairment ResearchCardiovascular Health and Risk FactorsDiabetes, Cardiovascular Risks, and Lipoproteins

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Early Adult to Midlife Cardiovascular Risk Factors and Cognitive Function

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Yaffe, Kristine, Vittinghoff, Eric, Pletcher, Mark J., Hoang, Tina D., Launer, Lenore J., Whitmer, Rachel A., Coker, Laura H., Sidney, Stephen·2014·Circulation

DOI 10.1161/circulationaha.113.004798PMC PMC4700881

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Abstract

Background—: Studies have linked midlife and late-life cardiovascular risk factors (CVRFs) to cognitive function, yet little is known about CVRF exposure in early adulthood and subsequent cognitive function. In addition, most studies rely on single assessments of CVRFs, which may not accurately reflect long-term exposure. We sought to determine the association between cumulative exposure to CVRFs from early to middle adulthood and cognitive function at midlife. Methods and Results—: In a prospective study of 3381 adults (age, 18–30 years at baseline) with 25 years of follow-up, we assessed cognitive function at year 25 (2010–2011) with the Digit Symbol Substitution Test, Stroop Test, and Rey Auditory Verbal Learning Test analyzed with standardized z scores. The primary predictor was 25-year cumulative exposure estimated by areas under the curve for resting systolic and diastolic blood pressures, fasting blood glucose, and total cholesterol. Higher cumulative systolic and diastolic blood pressures and fasting blood glucose were consistently associated with worse cognition on all 3 tests. These associations were significant primarily for exposures above recommended guidelines; cognitive test z scores were between 0.06 and 0.30 points less, on average, for each 1-SD increase in risk factor area under the curve after adjustment for age, race, sex, and education ( P <0.05 for all). Fewer significant associations were observed for cholesterol. Conclusions—: Cumulative exposure to CVRFs from early to middle adulthood, especially above recommended guidelines, was associated with worse cognition in midlife. The meaning of this association and whether it warrants more aggressive treatment of CVRFs earlier in life require further investigation.

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Authors: Yaffe, K., Vittinghoff, E., Pletcher, M. J., Hoang, T. D., Launer, L. J., Whitmer, R. A., Coker, L. H., & Sidney, S.
Affiliations: National Institutes of Health (US)
ORCID: Yaffe, Kristine
Vittinghoff, Eric
Pletcher, Mark J.
Launer, Lenore J.
Whitmer, Rachel A.
Sidney, Stephen
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-04-15
Volume: 129
Issue: 15
Pages: 1560-1567
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.113.004798
PMC: PMC4700881
OpenAlex: W2052534047
Cited by: 308
References: 55
Citations by year: 2026: 14 · 2025: 23 · 2024: 23 · 2023: 22 · 2022: 33 · 2021: 32 · 2020: 27 · 2019: 34 · 2018: 16 · 2017: 28 · 2016: 28 · 2015: 18 · 2014: 9
FWCI: 21.11
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institutes of Health
National Institute on Aging (AG 0005, Z01AG007380)
National Heart, Lung, and Blood Institute (HHSN268201300028C, HHS-N2-68201300029C, HHSN268201300027C, HHSN268200900041C, HHSN268201300026C, HHS-N2-68201300025C)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: cardiovascular risk factors, cognitive function, cumulative exposure, early adulthood, midlife, blood pressure, fasting blood glucose, total cholesterol, area under the curve, executive function, memory
MeSH terms: Adolescent, Adult, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Cholesterol, Cognition, Cognition Disorders, Female, Follow-Up Studies, Heart Failure, Humans, Hypertension, Male, Middle Aged, Myocardial Infarction, Neuropsychological Tests, Predictive Value of Tests, Prospective Studies, Risk Factors, Age Distribution, Stroke, Young Adult, Peripheral Arterial Disease

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