TY - JOUR
T1 - Associations between midlife (but Not Late-Life) elevated coronary heart disease risk and lower cognitive performance
T2 - Results from the framingham offspring study
AU - Armstrong, Nicole M.
AU - Bangen, Katherine J.
AU - Au, Rhoda
AU - Gross, Alden L.
N1 - Funding Information:
Funding for N.M.A. came from the National Institute on Aging Intramural Research Program. Funding for K.J.B. came from the US Department of Veterans Affairs (Career Development Award-2 1IK2CX000938), the Alzheimer’s Association (grant AARG-18-566254), and the Dana Foundation. Funding for R.A. came from the Alzheimer’s Association, the National Heart, Lung, and Blood Institute (contracts N01-HC-25195 and HHSN268201500001I), the National Institute on Aging (grants R01-AG016495, R01-AG008122, R01-AG033040, and R56-AG06210), and the National Institute of Neurological Disorders and Stroke (grant R01-NS017950). Funding for A.L.G. came from the National Institute on Aging (grant K01-AG050699). We gratefully acknowledge Kendra P. Davis for help with the models.
Publisher Copyright:
© 2019 Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2020. This work is written by (a) US Government employee(s) and is in the public domain in the US.
PY - 2019/12/31
Y1 - 2019/12/31
N2 - It is unclear how coronary heart disease (CHD) risk across the adult life span affects late-life cognition. We estimated associations of midlife and late-life elevated CHD risk with cognitive trajectories (general cognitive performance, processing speed/executive function, memory) in later life (after age 55 years or age 70 years) among 2,892 Framingham Offspring Study participants who had completed CHD risk assessments approximately every 4 years since 1971 and had undergone neuropsychological testing between 1999 and 2014. We stratified analyses by apolipoprotein E gene (APOE) ϵ4 allele carrier status. Using linear mixed-effects models, elevated CHD risk in midlife (age 55 years) was associated with lower levels of general cognitive performance (β = -0.560 standard deviation (SD) units, 95% confidence interval (CI): -0.874, -0.246), executive function (β = -0.624 SD units, 95% CI: -0.916, -0.332), and memory (β = -0.560 SD units, 95% CI: -0.907, -0.213) at age 70 years but not with rates of cognitive change. Late-life (age 70 years) elevated CHD risk, however, was associated with somewhat better levels of general cognitive performance and memory. There were associations between duration of elevated CHD risk during midlife and levels (but not trajectories) of later-life cognitive outcomes. Associations were not modified by APOE-ϵ4 status. These findings suggest that midlife elevated CHD risk is associated with lower cognition, independently of APOE-ϵ4 status, suggesting that risk of vascular disease may not contribute a "second hit" to AD risk.
AB - It is unclear how coronary heart disease (CHD) risk across the adult life span affects late-life cognition. We estimated associations of midlife and late-life elevated CHD risk with cognitive trajectories (general cognitive performance, processing speed/executive function, memory) in later life (after age 55 years or age 70 years) among 2,892 Framingham Offspring Study participants who had completed CHD risk assessments approximately every 4 years since 1971 and had undergone neuropsychological testing between 1999 and 2014. We stratified analyses by apolipoprotein E gene (APOE) ϵ4 allele carrier status. Using linear mixed-effects models, elevated CHD risk in midlife (age 55 years) was associated with lower levels of general cognitive performance (β = -0.560 standard deviation (SD) units, 95% confidence interval (CI): -0.874, -0.246), executive function (β = -0.624 SD units, 95% CI: -0.916, -0.332), and memory (β = -0.560 SD units, 95% CI: -0.907, -0.213) at age 70 years but not with rates of cognitive change. Late-life (age 70 years) elevated CHD risk, however, was associated with somewhat better levels of general cognitive performance and memory. There were associations between duration of elevated CHD risk during midlife and levels (but not trajectories) of later-life cognitive outcomes. Associations were not modified by APOE-ϵ4 status. These findings suggest that midlife elevated CHD risk is associated with lower cognition, independently of APOE-ϵ4 status, suggesting that risk of vascular disease may not contribute a "second hit" to AD risk.
KW - Alzheimer disease
KW - apolipoprotein E ϵ4
KW - cognition
KW - coronary heart disease
KW - life course
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U2 - 10.1093/aje/kwz210
DO - 10.1093/aje/kwz210
M3 - Article
C2 - 31576397
AN - SCOPUS:85080851585
VL - 188
SP - 2175
EP - 2187
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 12
ER -