Association Between Cardiovascular Health and Cognitive Performance: A Twins Study.

• Type of Material: Article
• Authors: Ambar Kulshreshtha, Emory University; Margarethe Goetz, Emory University; Alvaro Alonso, Emory University; Amit J. Shah, Emory University; J. Douglas Bremner, Emory University; Jack Goldberg, Vietnam Era Twin Registry; Viola Vaccarino, Emory University
• Language: English
• Date: 2019
• Publisher: IOS Press
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Copyright ©2020 IOS Press All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.3233/JAD-190217
• Title of Journal or Parent Work: Journal of Alzheimer's Disease
• ISSN: 1387-2877
• Volume: 71
• Issue: 3
• Start Page: 957
• End Page: 968
• Grant/Funding Information: This study was supported by K24HL077506, R01 HL68630, and R01 AG026255 to Dr. Vaccarino; and by K24 MH076955, R01 MH056120, and R01 HL088726 to Dr. Bremner from the National Institutes of Health; by the Emory University General Clinical Research Center MO1-RR00039; and by grant 0245115N from the American Heart Association.; Dr. Shah was supported by grant K23 HL127251.; Dr. Alonso was supported by grant U01 HL096902.; The United States Department of Veterans Affairs has provided financial support for the development and maintenance of the Vietnam Era Twin (VET) Registry.
• Keywords: prevention; risk factors; Epidemiology
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

BACKGROUND/OBJECTIVE: The 2020 Strategic Impact Goal introduced by the American Heart Association (AHA) aims at improving cardiovascular health (CVH) of all Americans by 20%. AHA defined ideal CVH across seven established modifiable risk factors for cardiovascular diseases. Prior studies have indicated that ideal CVH also benefits brain health and cognitive aging, but it is possible that this association is explained by familial factors. METHODS: We examined 272 male monozygotic and dizygotic twin pairs (total 544 subjects) free of overt cardiovascular disease and dementia from the Vietnam Era Twin Registry. Memory and learning were measured by Trail Making tests and Wechsler Memory Scale (Immediate and Delayed Memory tests and Visual Reproductive Test). Each of the seven CVH components (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was scored per established criterion. RESULTS: The mean age of the twins was 55 years, 96% were whites, and 61% monozygotic. When considering twins as individuals, for every unit increase in CVH score (indicating better cardiovascular health), twins demonstrated faster cognitive processing speed (Trail B: - 5.6 s, 95% CI - 10.3, - 0.9; p = 0.03) and better story recall, both immediate (0.35, 95% CI 0.06, 0.62; p = 0.02) and delayed (0.39, 95% CI 0.08, 0.70; p = 0.01). CONCLUSIONS: Better CVH is associated with better cognitive health in several domains. As suggested by within-pair analysis, this association is largely explained by familial factors, implying that early life exposures are shared determinants of both brain health and cardiovascular health.