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Cognitive function predicts first-time stroke and heart disease

Jacob S Elkins1, David S Knopman, Kristine Yaffe

  • 1University of California, San Francisco, CA 94143, USA. jacob.elkins@ucsfmedctr.org

Neurology
|May 25, 2005
PubMed

Insights

Impaired cognitive function in middle-aged adults can predict future cardiovascular disease risk, independent of other known risk factors. This finding highlights cognitive tests as potential early indicators for cardiovascular events.

Area of Science:

  • Neurology
  • Cardiology
  • Public Health

Background:

  • Vascular injury in the brain may manifest as early cognitive impairment.
  • Identifying early predictors of cardiovascular disease (CVD) is crucial for timely intervention.

Purpose of the Study:

  • To determine if cognitive dysfunction predicts subsequent cardiovascular events.
  • To assess cognitive function as an early marker of brain vascular injury.

Main Methods:

  • 12,096 middle-aged participants from the Atherosclerosis Risk in Communities (ARIC) Study without prior stroke or coronary heart disease (CHD).
  • Cognitive function assessed using Digit-Symbol Substitution Test (DSST), Word Fluency Test, and Delayed Word Recall Test.
  • Cox proportional hazards analysis used to evaluate cognitive scores as predictors of incident cardiovascular events.

Main Results:

  • Lower cognitive test scores predicted increased risk of cardiovascular events over a median 6.4-year follow-up.
  • The association remained significant after adjusting for established vascular risk factors.
  • The predictive power of cognitive tests was comparable to established CVD risk markers like left ventricular hypertrophy.

Conclusions:

  • Cognitive test performance below demographic norms is an independent predictor of incident cardiovascular disease in middle-aged individuals.
  • Cognitive function may serve as an early indicator of subclinical vascular injury.
  • These findings support the integration of cognitive assessments in cardiovascular risk prediction.
Abstract

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