title: Association between northern Manhattan study global vascular risk score and successful aging.
abstract: OBJECTIVE
  To examine the association between successful aging without subsequent cognitive decline (SA-ND) and the Northern Manhattan Study (NOMAS) global vascular risk score (GVRS), which is predictive of stroke, myocardial infarction, and vascular death.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A stroke-free sample of Hispanic, black, and white participants living in the same community enrolled in a magnetic resonance imaging (MRI) substudy of NOMAS, a population-based prospective cohort study.
  
  
  METHODS
  One thousand two hundred ninety individuals in whom a cognitive screen was administered at baseline and at enrollment in the MRI substudy.
  
  
  METHODS
  SA-ND was based on disease, disability, and cognitive function. The GVRS includes age, sex, race and ethnicity, waist circumference, alcohol intake, smoking, physical activity, blood pressure, antihypertensive medication use, fasting blood sugar, lipid levels, and peripheral vascular disease.
  
  
  RESULTS
  Data at baseline and follow-up were available for 1,162 participants (mean age 70 ± 9; 61% women; 13% white, 16% black, 69% Hispanic; mean GVRS 8.6 ± 0.9). Logistic regression, adjusted for education, socioeconomic status, and follow-up time, showed that the odds of SA-ND were 38% greater for each additional 1-point decrease on the GVRS (odds ratio = 1.38, 95% confidence interval = 1.17-1.61; P < .001). An inverse dose-response was observed between quartiles of GVRS and SA-ND. Greater diastolic blood pressure in participants taking antihypertensive medication and a history of claudication (P = .003) or peripheral arterial disease (P < .001) were inversely associated with SA-ND in the fully adjusted model.
  
  
  CONCLUSIONS
  Potentially modifiable vascular risk factors were independently associated with SA-ND in a multiethnic community-based sample. Improvements in GVRSs could help promote healthy longevity in the aging population.
authors.affiliation: Evelyn F. McKnight Brain Institute, Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Jessica R L
authors.initials: JR
authors.lastname: Warsch
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.forename: Myunghee C
authors.initials: MC
authors.lastname: Paik
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology*