Brain Health

Early cardiovascular disease may accelerate cognitive decline

There’s good news and bad news regarding cardiovascular disease (CVD), which is associated with cognitive impairment and dementia in older people. While the numbers are declining in those over 50, the numbers for those under 50 have either remained steady or increased.

Until recently, most of the research on the link between CVD and cognitive impairment and dementia has been focused on the former age group. But new research published in the journal Neurology looked at the effects of premature CVD; that is, the impact of cardiovascular disease on younger adults.

The Research

A team of researchers studied data from participants in the Coronary Artery Risk Development in Young Adults (CARDIA), who were between 18 to 30 years old at the time they enrolled in the study. The participants had exams every two to five years for 30 years total, when five cognitive tests were administered to measure any changes. Some of the participants also had MRIs to measure white matter hyperintensity and white matter integrity.

Other participant demographics:

• Just over half were female

• Just under half were Black

• All were from (4) cities in the United States

The Results

And the end of the 30-year study, the 3,146 participants had a mean age of 55 years. Among the group, the researchers found that:

• 147 participants had developed one or more premature CVD events (126 of those were coronary heart disease or stroke) over the 30 years.

• The mean age of the first CVD event was 48.4 years.

• Participants who had a premature CVD event were more likely to be male, older, and Black and had a lower household income, decreased access to education, and more risk factors for a cardiovascular disease events (e.g., poor diet and less physical activity).

• Participants with early CVD were almost three times as likely to have accelerated cognitive decline (13% vs. 5%) than those without early CVD.

It’s interesting to note that participants with premature CVD performed worse on all cognitive tests—especially processing speed and executive function—except one: verbal fluency.

Lower verbal fluency was only linked to premature CVD in women.

So, why might early CVD accelerate cognitive decline?

“Cardiovascular disease is closely linked to [the] progression of cerebrovascular disease due to alteration of cerebral blood flow, increased cerebral inflammation and microvascular stress, shared vascular risk factors,” explains Dr. Sandra Narayanan, a board-certified vascular neurologist and neurointerventional surgeon who was not involved in the study, “and in many cases, shared pathophysiology.”

The takeaway

So what’s the takeaway regarding early CVD and cognitive decline?

Protect the heart to protect the brain. That means not smoking, maintaining a healthy weight, staying physically active and following a healthy diet. Additionally, treat CVD risk factors aggressively, event at a young age, to help prevent declines in cognitive function and brain health.

MBJ

Wendy Burt-Thomas writes about the brain, mental health and parenting.

Check out the original research:

https://n.neurology.org/content/early/2023/01/25/WNL.0000000000206825

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