Heart Health and Cognitive Decline: Who Fares Better?

By Jonathan Springston, Editor, Relias Media

Although men at midlife are more likely to be diagnosed with heart disease or experience a stroke — and more likely to be managing related risk factors (e.g., high blood pressure, diabetes) — the associated negative effects on cognition might be worse for women of the same age.

Investigators studied the data of more than 1,800 people who were age 50 to 69 years at the time they enrolled in the Mayo Clinic Study of Aging. Of these, 1,465 were living with at least one cardiovascular risk factor or disease (767 men, 698 women). Every 15 months, for an average of three years, a coordinator evaluated these patients with nine tests of executive function, language, memory, and spatial skills; results were totaled to calculate a composite cognitive score.

Researchers observed that cardiovascular risk factors and diseases were more strongly associated with cognitive function among women. For instance, the authors noted heart disease was connected to a more than two-fold greater decline in composite cognitive test scores for women vs. men.

“We found that certain cardiovascular conditions, such as diabetes, heart disease, and dyslipidemia … had stronger associations with cognitive decline in women compared to men,” Michelle M. Mielke, PhD, study author, said in a statement.

In addition to its observational design, this work is limited by the fact that all participants are from one county in Minnesota. This makes it difficult to apply these results widely.

“More research is needed to examine sex differences in the relationships between the cardiovascular risk factors and specific biomarkers of brain disease like white matter hyperintensities, areas of dead tissue, and overall white matter integrity in midlife,” Mielke said. “That may help us better understand the sex-specific mechanisms by which the cardiovascular conditions and risk factors contribute to cognitive impairment in both women and men.”

In the upcoming January 30 issue of Internal Medicine Alert, author Seema Gupta, MD, MSPH, explains the latest dietary guidance from the American Heart Association, which emphasizes the importance of an overall lifetime heart-healthy diet and the vital role of nutrition early in life.

“Most importantly, these guidelines aim to meet people where they are,” Gupta writes. “Whether someone predominantly eats at restaurants or is a truck driver who lives on a tight budget, everyone can benefit from a heart-healthy dietary pattern. The guidelines emphasize that a one-size-fits-all approach may no longer be needed. A heart-healthy dietary pattern can be for everyone and be consistent with personal preferences, lifestyles, and religious and cultural customs.”

For more on this and related subjects, be sure to read the latest issues of Clinical Cardiology Alert and Neurology Alert.