Cardiovascular risk profile and cognitive function in young, middle-aged, and elderly subjects

Stroke. 2013 Jun;44(6):1543-9. doi: 10.1161/STROKEAHA.111.000496. Epub 2013 May 2.


Background and purpose: Cognitive decline occurs earlier than previously realized and is already evident at the age of 45. Because cardiovascular risk factors are established risk factors for cognitive decline in old age, we investigated whether cardiovascular risk factors are also associated with cognitive decline in young and middle-aged groups.

Methods: The cross-sectional study included 3778 participants aged 35 to 82 years (mean age, 54 years) and free of cardiovascular disease and stroke. Cognitive function was measured with the Ruff Figural Fluency Test (RFFT; worst score, 0; best score, 175 points) and the Visual Association Test (VAT; worst score, 0; best score, 12 points). Overall cardiovascular risk was assessed with the Framingham Risk Score (FRS) for general cardiovascular disease (best score, -5; worst score, 33 points).

Results: Mean RFFT score (SD) was 70 (26) points, median VAT score (interquartile range) was 10 (9-11) points, and mean FRS (SD) was 10 (6) points. Using linear regression analysis adjusting for educational level, RFFT was negatively associated with FRS. RFFT score decreased by 1.54 points (95% confidence interval, -1.66 to -1.44; P<0.001) per point increase in FRS. This negative association was not only limited to older age groups, but also found in the young (35-44 years). The main influencing components of the FRS were age (P<0.001), diabetes mellitus (P=0.001), and smoking (P<0.001). Similar results were found for VAT score as outcome measure.

Conclusions: In this large population-based cohort, a worse overall cardiovascular risk profile was associated with poorer cognitive function. This association was already present in young adults aged 35 to 44 years.

Keywords: amnesia; cardiovascular disease; cross-sectional analysis; executive function; risk assessment.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Cognition Disorders / complications*
  • Cognition Disorders / physiopathology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Outcome Assessment, Health Care
  • Risk Factors