A prospective US cohort study indicated that premature cardiovascular disease (CVD before 60 years) is associated with worse midlife cognition and white matter health, which is not entirely driven by stroke/TIA and even independent of CVD risk factors. The study included 3,146 participants, who were 18-30 years at baseline (1985-86, 57% women, 48% Black) and followed up to 30 years. The mean age was 55.1 years, with 5% having premature CVD. Adjusting for demographics, education, literacy, income, depressive symptoms, physical activity, diet, and APOE, premature CVD was associated with lower cognition in 4 out of 5 domains: global cognition (-0.22), verbal memory (-0.28), processing speed (-0.46), and executive function (-0.38). Premature CVD was associated with greater white matter hyperintensity (total, temporal, and parietal lobes) and higher white matter mean diffusivity (total and temporal lobes) in MRI after adjustment for covariates in a subset of 656 participants. These associations remained significant after adjusting for cardiovascular risk factors and excluding those with stroke/TIA. Premature CVD was also associated with accelerated cognitive decline over 5 years (adjusted odds ratio 3.07). The findings suggest that preventing CVD in early adulthood may delay the onset of cognitive decline and promote brain health. A previous study in the cohort has also linked cardiovascular risk factors in mid-life to cognitive decline. Previous research has linked CVD with an increased risk for brain impairment in older adults. Source: https://n.neurology.org/
