Cardiovascular Risk Factors From Childhood and Midlife Cognitive Performance: The Young Finns Study

Suvi P Rovio; Katja Pahkala; Jaakko Nevalainen; Markus Juonala; Pia Salo; Mika Kähönen; Nina Hutri-Kähönen; Terho Lehtimäki; Eero Jokinen; Tomi Laitinen; Leena Taittonen; Päivi Tossavainen; Jorma S A Viikari; Juha O Rinne; Olli T Raitakari

doi:10.1016/j.jacc.2017.02.060

Cardiovascular Risk Factors From Childhood and Midlife Cognitive Performance: The Young Finns Study

J Am Coll Cardiol. 2017 May 9;69(18):2279-2289. doi: 10.1016/j.jacc.2017.02.060.

Authors

Affiliations

¹ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. Electronic address: suvi.rovio@utu.fi.
² Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland.
³ School of Health Sciences, University of Tampere, Tampere, Finland.
⁴ Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
⁵ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
⁶ Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
⁷ Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
⁸ Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
⁹ Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
¹⁰ Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
¹¹ Vaasa Central Hospital, Vaasa, Finland; Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.
¹² Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.
¹³ Turku PET Centre and Department of Neurology, University of Turku and Turku University Hospital, Turku, Finland.
¹⁴ Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.

PMID: 28473132
DOI: 10.1016/j.jacc.2017.02.060

Abstract

Background: In adults, high blood pressure (BP), adverse serum lipids, and smoking associate with cognitive deficits. The effects of these risk factors from childhood on midlife cognitive performance are unknown.

Objectives: This study sought to investigate the associations between childhood/adolescence cardiovascular risk factors and midlife cognitive performance.

Methods: From 1980, a population-based cohort of 3,596 children (baseline age: 3 to 18 years) have been followed for 31 years in 3- to 9-year intervals. BP, serum lipids, body mass index, and smoking were assessed in all follow-ups. Cumulative exposure as the area under the curve for each risk factor was determined in childhood (6 to 12 years), adolescence (12 to 18 years), and young adulthood (18 to 24 years). In 2011, cognitive testing was performed in 2,026 participants aged 34 to 49 years.

Results: High systolic BP, elevated serum total-cholesterol, and smoking from childhood were independently associated with worse midlife cognitive performance, especially memory and learning. The number of early life risk factors, including high levels (extreme 75th percentile for cumulative risk exposure between ages 6 and 24 years) of systolic BP, total-cholesterol, and smoking associated inversely with midlife visual and episodic memory and visuospatial associative learning (-0.140 standard deviations per risk factor, p < 0.0001) and remained significant after adjustment for contemporaneous risk factors. Individuals with all risk factors within recommended levels between ages 6 and 24 years performed 0.29 standard deviations better (p = 0.006) on this cognitive domain than those exceeding all risk factor guidelines at least twice. This difference corresponds to the effect of 6 years aging on this cognitive domain.

Conclusions: Cumulative burden of cardiovascular risk factors from childhood/adolescence associate with worse midlife cognitive performance independent of adulthood exposure.

Keywords: blood pressure; body mass index; cognitive performance; serum cholesterol; smoking.

MeSH terms

Adolescent
Blood Pressure*
Cardiovascular Diseases
Child
Child, Preschool
Cognition*
Female
Humans
Lipids / blood*
Longitudinal Studies
Male
Risk Factors
Smoking / adverse effects*
Young Adult

Substances

Lipids