title: Sex differences in the association of Framingham Cardiac Risk Score with cognitive decline in community-dwelling elders without clinical heart disease.
abstract: OBJECTIVE
  To investigate a possible link between cardiovascular risk factors and age-related cognitive decline, the association of the 1998 Framingham Cardiac Risk Score (FCRS) with the trajectory of cognitive function test (CFT) performance over an 18 year period was examined in adults 50 years and older without clinical heart disease at baseline.
  
  
  METHODS
  Participants were 985 men and women who had assessments of cognitive function at 3- to 4-year intervals. The association of FCRS category with CFT score trajectory was examined using mixed-effects models stratified by sex and controlling for age, educational level, and number of successive cognitive assessments.
  
  
  RESULTS
  At baseline, median FCRS corresponded to a 14% risk of a coronary heart disease event within 10 years for men and an 8% risk for women; 31% of men and 6% of women were at high (>20%) risk. In longitudinal analyses, women with FCRS risk higher than 7% had a higher rate of decline on tests of verbal fluency (p values < .05) and long-term recall (p values < .01) compared with low-risk women; modest, but significant (p values < .05), differences in the trajectory of Mini-Mental State Examination and Trail-Making Test B scores were also apparent. FCRS category was not related to the rate of decline in CFT performance in men.
  
  
  CONCLUSIONS
  For older women, very low levels of risk of coronary heart disease were associated with preservation of cognitive function for 10 years, suggesting that the maintenance of cardiovascular health may slow cognitive decline. The minimal association in men, who were at higher baseline risk, may be due to the selective attrition of men with greater cognitive decline.
authors.affiliation: Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA 92093, USA. glaughlin@ucsd.edu
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.forename: Linda K
authors.initials: LK
authors.lastname: McEvoy
authors.forename: Denise
authors.initials: D
authors.lastname: von Mühlen
authors.forename: Lori B
authors.initials: LB
authors.lastname: Daniels
authors.forename: Donna
authors.initials: D
authors.lastname: Kritz-Silverstein
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Bergstrom
authors.forename: Kevin
authors.initials: K
authors.lastname: Cummins
authors.forename: Claudia
authors.initials: C
authors.lastname: Der-Martirosian
authors.forename: Simerjot K
authors.initials: SK
authors.lastname: Jassal
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
mesh_terms: D000368:Aged; D000375:Aging; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012111:Residence Characteristics; D018570:Risk Assessment; D012727:Sex Characteristics; D013997:Time Factors