Modifiable lifestyle behaviors and control or avoidance of cardiovascular risk factors are among the most promising strategies for prevention of cognitive decline and dementia, but is this true even for individuals with a high vascular risk profile? According to a new study published in the American Journal of Cardiology, the answer is yes. In the study, Sheba Medical Center researchers led by Prof. David Tanne found that cardiovascular health predicts cognitive decline 2 decades later among patients with pre-existing coronary artery disease.

Participants were 200 men (mean age at baseline 57.3 ± 6.3 years) with stable coronary artery disease in a large multicenter trial who completed computerized cognitive assessment [NeuroTrax] 15 and 20 years after baseline. Better cardiovascular health at baseline was associated with slower decline in overall cognitive performance, as well as executive function and visual spatial processing. Linear mixed-effect models were adjusted for age, education, employment, place of birth, and height at baseline. Results were similar after additional adjustment for depressive symptoms and cerebrovascular reactivity, as well as exclusion of participants with stroke and dementia. Cardiovascular health was measured by 3 health factors (fasting plasma glucose, low-density lipoprotein cholesterol, blood pressure) and 4 health behaviors (smoking, obesity, physical activity and adherence to Mediterranean diet).

In this unprecedented study on the relationship between cardiovascular health and cognitive decline in patients with preexisting coronary artery disease, the authors demonstrate that lifestyle factors are important predictors of late-life decline in cognitive function even among high-risk patients. Notably, the authors identify “use of a validated computerized assessment tool to quantify cognitive function globally and in specific domains” [NeuroTrax] as a strength of the study.

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Citation:
Lutski, M, Weinstein, G., Goldbourt, U., and Tanne, D. (2018). Cardiovascular health and cognitive decline 2 decades later in men with preexisting coronary artery disease. American Journal of Cardiology, 121, 410–415. PMID: 29273206