Midlife vascular risk factors and midlife cognitive status in relation to prevalence of mildcognitive impairment and dementia in later life: The atherosclerosis risk in communities study

Knopman DS¹, Gottesman RF², Sharrett AR³, Tapia AL4, DavisThomas S⁴, Windham BG⁵, Coker L⁶, Schneider ALC², Alonso A⁷, Coresh J³, Albert MS², Mosley TH Jr⁵.

Abstract

INTRODUCTION:

The interplay between midlife vascular risk factors and midlife cognitive function with later life mild cognitive impairment(MCI) and dementia (DEM) is not well understood.

METHODS:

In the Atherosclerosis Risk in Communities Study, cardiovascular risk factors and cognition were assessed in midlife, ages 45-64 years. In 2011-2013, 20-25 years later, all consenting Atherosclerosis Risk in Communities participants underwent a cognitive and neurological evaluation and were given adjudicated diagnoses of cognitively normal, MCI, or DEM.

RESULTS:

In 5995 participants with complete covariate data, midlife diabetes, hypertension, obesity, and hypercholesterolemia were associated with late-life MCI and DEM. Low midlife cognition function was also associated with greater likelihood of late-life MCI or DEM. Both midlife vascular risk factors and midlife cognitive function remained associated with later life MCI or DEM when both were in the model.

DISCUSSION:

Later life MCI and DEM were independently associated with midlife vascular risk factors and midlife cognition.

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¹ Department of Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address: knopman@mayo.edu.

² Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

⁴ Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

⁵ Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

⁶ Division of Public Health Sciences, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.

⁷ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.