title: Cognitive ability, lifestyle risk factors, and two-year survival in first myocardial infarction men: A Swedish National Registry study.
abstract: BACKGROUND
  General cognitive ability (CA) is positively associated with later physical and mental health, health literacy, and longevity. We investigated whether CA estimated approximately 30years earlier in young adulthood predicted lifestyle-related risk factors and two-year survival in first myocardial infarction (MI) male patients.
  
  
  METHODS
  Young adulthood CA estimated through psychometric testing at age 18-20years was obtained from the mandatory military conscript registry (INSARK) and linked to national quality registry SWEDEHEART/RIKS-HIA data on smoking, diabetes, hypertension, obesity (BMI>30kg/m2) in 60years or younger Swedish males with first MI. Patients were followed up in the Cause of Death registry. The 5659 complete cases (deceased=106, still alive=5553) were descriptively compared. Crude and adjusted associations were modelled with logistic regression.
  
  
  RESULTS
  After multivariable adjustment, one SD increase in CA was associated with a decreased odds ratio of being a current smoker (0.63 [0.59, 0.67], P<0.001), previous smoker (0.79 [0.73, 0.84], P<0.001), having diabetes (0.82 [0.74, 0.90], P<0.001), being obese (0.90 [0.84, 0.95], P<0.001) at hospital admission, and an increased odds ratio of two-year survival (1.26 [1.02, 1.54], P<0.001). CA was not associated with hypertension at hospital admission (1.03 [0.97, 1.10], P=0.283).
  
  
  CONCLUSIONS
  This study found substantial inverse associations between young adulthood CA, and middle-age lifestyle risk factors smoking, diabetes, and obesity, and two-year survival in first MI male patients. CA assessment might benefit risk stratification and possibly aid further tailoring of secondary preventive strategy.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Electronic address: john.wallert@pubcare.uu.se.
authors.forename: John
authors.initials: J
authors.lastname: Wallert
authors.affiliation: Department of Psychology, Umeå University, Umeå, Sweden.
authors.forename: Guy
authors.initials: G
authors.lastname: Madison
authors.affiliation: Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden/Department of Medical Sciences: Cardiology, Uppsala University, Uppsala, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Held
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Olsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D003071:Cognition / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods*; D011594:Psychometrics / Q000379:methods; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: Behaviour and behavioural mechanisms; Cardiovascular disease; Intelligence; Lifestyle; Risk factors; Secondary prevention