Cardiovascular risk factors and cognitive decline in middle-aged adults

David S Knopman, L. L. Boland, T. Mosley, G. Howard, D. Liao, M. Szklo, P. McGovern, A. R. Folsom

Research output: Contribution to journalArticle

629 Citations (Scopus)

Abstract

Objective: To perform serial neuropsychological assessments to detect vascular risk factors for cognitive decline in the Atherosclerosis Risk in Communities cohort, a large biracial, multisite, longitudinal investigation of initially middle-aged individuals. Methods: The authors administered cognitive assessments to 10,963 individuals (8,729 white individuals and 2,234 black individuals) on two occasions separated by 6 years. Subjects ranged in age at the first assessment from 47 to 70 years. The cognitive assessments included the delayed word recall (DWR) test, a 10-word delayed free recall task in which the learning phase included sentence generation with the study words, the digit symbol subtest (DSS) of the Wechsler Adult Intelligence Scale-Revised and the first-letter word fluency (WF) test using letters F, A, and S. Results: In multivariate analyses (controlling for demographic factors), the presence of diabetes at baseline was associated with greater decline in scores on both the DSS and WF (p < 0.05), and the presence of hypertension at baseline was associated with greater decline on the DSS alone (p < 0.05). The association of diabetes with cognitive decline persisted when analysis was restricted to the 47- to 57-year-old subgroup. Smoking status, carotid intima-media wall thickness, and hyperlipidemia at baseline were not associated with change in cognitive test scores. Conclusions: Hypertension and diabetes mellitus were positively associated with cognitive decline over 6 years in this late middle-aged population. Interventions aimed at hypertension or diabetes that begin before age 60 might lessen the burden of cognitive impairment in later life.

Original languageEnglish (US)
Pages (from-to)42-48
Number of pages7
JournalNeurology
Volume56
Issue number1
StatePublished - Jan 9 2001

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Hypertension
Carotid Intima-Media Thickness
Hyperlipidemias
Intelligence
Atherosclerosis
Diabetes Mellitus
Multivariate Analysis
Smoking
Demography
Learning
Cognitive Dysfunction
Population
vascular factor

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Knopman, D. S., Boland, L. L., Mosley, T., Howard, G., Liao, D., Szklo, M., ... Folsom, A. R. (2001). Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology, 56(1), 42-48.

Cardiovascular risk factors and cognitive decline in middle-aged adults. / Knopman, David S; Boland, L. L.; Mosley, T.; Howard, G.; Liao, D.; Szklo, M.; McGovern, P.; Folsom, A. R.

In: Neurology, Vol. 56, No. 1, 09.01.2001, p. 42-48.

Research output: Contribution to journalArticle

Knopman, DS, Boland, LL, Mosley, T, Howard, G, Liao, D, Szklo, M, McGovern, P & Folsom, AR 2001, 'Cardiovascular risk factors and cognitive decline in middle-aged adults', Neurology, vol. 56, no. 1, pp. 42-48.
Knopman DS, Boland LL, Mosley T, Howard G, Liao D, Szklo M et al. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology. 2001 Jan 9;56(1):42-48.
Knopman, David S ; Boland, L. L. ; Mosley, T. ; Howard, G. ; Liao, D. ; Szklo, M. ; McGovern, P. ; Folsom, A. R. / Cardiovascular risk factors and cognitive decline in middle-aged adults. In: Neurology. 2001 ; Vol. 56, No. 1. pp. 42-48.
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