title: Cardiovascular risk score, cognitive decline, and dementia in older Mexican Americans: the role of sex and education.
abstract: BACKGROUND
  The purpose of this study was to examine the associations of cardiovascular disease (CVD) risk with cognitive decline and incidence of dementia and cognitive impairment but not dementia (CIND) and the role of education as a modifier of these effects.
  
  
  RESULTS
  One thousand one hundred sixteen Mexican American elderly were followed annually in the Sacramento Area Latino Study on Aging. Our sex-specific 10-year CVD risk score included baseline age, systolic blood pressure, total cholesterol, high-density lipoprotein, smoking, body mass index, and diabetes. From adjusted linear mixed models, errors on the Modified Mini-Mental State Exam (3MSE) were annually 0.41% lower for women at the 25th percentile of CVD risk, 0.11% higher at the 50th percentile, and 0.83% higher at the 75th percentile (P value of CVDrisk×time <0.01). In men, 3MSE errors were annually 1.76% lower at the 25th percentile of CVD risk, 0.96% lower at the 50th percentile, and 0.12% higher at the 75th percentile (P value of CVDrisk×time <0.01). From adjusted linear mixed models, the annual decrease in the Spanish and English Verbal Learning Test score was 0.09 points for women at the 25th percentile of CVD risk, 0.10 points at the 50th percentile, and 0.12 points at the 75th percentile (P value of CVDrisk×time=0.02). From adjusted Cox models in women, compared with having <6 years of education, having 12+ years of education was associated with a 76% lower hazard of dementia/CIND (95% CI, 0.08 to 0.71) at the 25th percentile of CVD risk and with a 45% lower hazard (95% CI, 0.28 to 1.07) at the 75th percentile (P value of CVDrisk×education=0.05).
  
  
  CONCLUSIONS
  CVD risk score may provide a useful tool for identifying individuals at risk for cognitive decline and dementia.
authors.affiliation: Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA 94107, USA. Adina.zekialhazzouri@ucsf.edu
authors.forename: Adina
authors.initials: A
authors.lastname: Zeki Al Hazzouri
authors.forename: Mary N
authors.initials: MN
authors.lastname: Haan
authors.forename: John M
authors.initials: JM
authors.lastname: Neuhaus
authors.forename: Mark
authors.initials: M
authors.lastname: Pletcher
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Peralta
authors.forename: Lenny
authors.initials: L
authors.lastname: López
authors.forename: Eliseo J
authors.initials: EJ
authors.lastname: Pérez Stable
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002318:Cardiovascular Diseases / Q000208:ethnology*; D003072:Cognition Disorders / Q000208:ethnology*; D015331:Cohort Studies; D003704:Dementia / Q000208:ethnology*; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012923:Social Class; D014481:United States / Q000453:epidemiology