Cardiovascular disease and cognitive performance in middle-aged and elderly men.
BACKGROUND
Decline of cognitive function with age may be due, in part, to atherosclerotic changes. The aim of the present study was to determine the relative contribution of cardiovascular disease (CVD) to cognitive functioning in middle-aged and elderly men.


METHODS
In a cross-sectional study, cognitive tests were administered to 400 independently living men aged 40-80 years. Compound scores were calculated for memory function, processing capacity/speed, and executive function. The MMSE was used as a measure of global cognitive function. Carotid intima-media thickness, pulse wave velocity and ankle brachial blood pressure index were assessed as measures of sub-clinical CVD. The adjusted association of sub-clinical and prevalent CVD with neuropsychological test scores in the total group and in subgroups was assessed by linear regression analysis.


RESULTS
Increased IMT was associated with lower scores on memory performance, and increased PWV was associated with lower scores on processing capacity and executive functioning. Compared with subjects with no CVD, both sub-clinical and prevalent cardiovascular diseases were related to a lower memory performance, beta's (95% CI) were -0.45 (-0.83, -0.07) and -0.45 (-0.84, 0.01), respectively. These associations were present in both middle-aged and elderly men. Furthermore, we observed that for subjects who had sub-clinical or prevalent cardiovascular disease the distribution of MMSE-scores was shifted toward lower values; the distributions were statistically different (p=0.003).


CONCLUSIONS
The results of this study support a relation of sub-clinical CVD with cognitive functioning in middle-aged and elderly men. These results suggest that actions to prevent cognitive decline by preventing atherosclerosis should be taken before middle age.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
M
M
Muller
D E
DE
Grobbee
A
A
Aleman
M
M
Bots
Y T
YT
van der Schouw
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D050197:Atherosclerosis / Q000453:epidemiology*; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence