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Midlife cardiovascular risk factors and late cognitive impairment

  • NEURO-EPIDEMIOLOGY
  • Published:
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Abstract

Cardiovascular risk factors increase the risk of dementia in later life. The aims of the current study were to assess the effect of multiple midlife cardiovascular risk factors on the risk of cognitive impairment in later life, and to assess the validity of the previously suggested CAIDE Study risk score predicting dementia risk 20 years later. A total of 2,165 Finnish twins were followed and at the end of the follow-up their cognitive status was assessed with a validated telephone interview. The assessment of the risk factors at baseline was based on a self-report questionnaire. Relative risk ratios (RR) were calculated and receiver operating characteristic analyses performed. Midlife obesity (RR 2.42, 95 % CI 1.47–3.98), hypertension (RR 1.38, 95 % CI 1.01–1.88) and low leisure time physical activity (RR 2.52, 95 % CI 1.10–5.76) increased the risk of cognitive impairment after a mean follow-up of 22.6 ± 2.3 years. Hypercholesterolemia did not significantly increase the risk (RR 1.52, 95 % CI 0.92–2.51). Overweight individuals who gained more than 10 % weight between 1981 and 1990 had an increased risk of cognitive impairment (RR 4.27, 95 % CI 1.62–11.2). The CAIDE Study risk score combining various individual risk factors had an area-under-curve of 0.74 (95 % CI 0.69–0.79, n = 591), and there was a strong association between an increasing risk score and the risk of cognitive impairment. The results indicate that multiple midlife cardiovascular risk factors increase the risk of cognitive impairment in later life. Also, a risk score including easily measurable midlife factors predicts an individual’s cognitive impairment risk well.

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Abbreviations

AD:

Alzheimer’s disease

CAIDE:

Finnish Cardiovascular Risk Factors, Aging and Dementia study

MZ:

Monozygotic

DZ:

Dizygotic

MICF:

Mild impairment in cognitive function

BMI:

Body mass index

MET:

Metabolic equivalent

ApoE:

Apolipoprotein E

RR:

Relative risk ratio

95 % CI:

95 % confidence interval

EPV:

Events per variable

ROC:

Receiver operating characteristic

AUC:

Area-under-curve

OR:

Odds ratio

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Acknowledgments

The skilful assistance of research nurses Ulla Kulmala-Gråhn, Maarit Mantere and Kristiina Saanakorpi in interviewing the subjects is gratefully acknowledged. The assistance of Maarit Lappalainen at FIMM with ApoE genotyping is acknowledged. This study was financially supported by the Academy of Finland (project #205954), the Sigrid Juselius Foundation and Clinical grants of Turku University Hospital (EVO). The Finnish Twin Cohort study is part of the Academy of Finland Center of Excellence in Complex Disease Genetics (grant #s 213506, 129680).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland

    Jyri J. Virta & Juha O. Rinne

  2. Department of Public Health, Hjelt Institute, University of Helsinki, P.O. Box 41, 00014, Helsinki, Finland

    Jyri J. Virta, Kauko Heikkilä, Markku Koskenvuo & Jaakko Kaprio

  3. Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland

    Jaakko Kaprio

  4. Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland

    Ismo Räihä

  5. Department of Internal Medicine, Turku City Hospital, Turku, Finland

    Ismo Räihä

  6. Institute for Molecular Medicine, Helsinki, Finland

    Markus Perola & Jaakko Kaprio

  7. Unit for Genetic Epidemiology, National Institute for Health and Welfare, Helsinki, Finland

    Markus Perola

  8. Department of Neurology, University of Turku and Turku University Hospital, Turku, Finland

    Juha O. Rinne

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  1. Jyri J. Virta
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Correspondence to Jyri J. Virta.

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Virta, J.J., Heikkilä, K., Perola, M. et al. Midlife cardiovascular risk factors and late cognitive impairment. Eur J Epidemiol 28, 405–416 (2013). https://doi.org/10.1007/s10654-013-9794-y

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  • DOI: https://doi.org/10.1007/s10654-013-9794-y

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