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Pharmacological treatment of increased vascular risk and cognitive performance in middle-aged and old persons:
Marlise E A van Eersel1, Sipke T Visser2, Hanneke Joosten3
1University Center for Geriatric Medicine, University of Groningen, University Medical Center Groningen, AA41, PO Box 30.001, 9700, RB, Groningen, The Netherlands. mea.eersel@umcg.nl.
Insights
Lowering vascular risk factors through treatment did not significantly alter cognitive performance compared to no treatment. This suggests that managing vascular risk may inherently preserve cognitive function over time.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Lowering vascular risk is linked to reduced cardiovascular disease and dementia.
- The impact of pharmacological treatment for vascular risk on general cognitive performance remains unclear.
Purpose of the Study:
- To compare cognitive performance changes in individuals treated for vascular risk factors versus those untreated.
- To investigate if pharmacological interventions for vascular risk preserve cognitive function.
Main Methods:
- Longitudinal observational study with 256 treated and 1678 control participants.
- Cognitive performance assessed using Ruff Figural Fluency Test (RFFT) and Visual Association Test (VAT) over 5.5 years.
- Analyses included matched samples and propensity score adjustments due to nonrandomized treatment allocation.
Main Results:
- No statistically significant difference in cognitive performance change between treated and untreated groups after adjustments.
- Mean estimated difference in cognitive change was -0.10 (95% CI -0.21 to 0.01).
- Results were consistent in matched samples and after propensity score adjustment.
Conclusions:
- Cognitive performance changes were similar in both treated and untreated individuals.
- Findings suggest that lowering vascular risk, whether through treatment or other means, may preserve cognitive function.
- Further research may be needed to elucidate the specific mechanisms of cognitive preservation.
Background:
Lowering vascular risk is associated with a decrease in the prevalence of cardiovascular disease and dementia. However, it is still unknown whether lowering of vascular risk with pharmacological treatment preserves cognitive performance in general. Therefore, we compared the change in cognitive performance in persons with and without treatment of vascular risk factors.
Methods:
In this longitudinal observational study, 256 persons (mean age, 58 years) were treated for increased vascular risk during a mean follow-up period of 5.5 years (treatment group), whereas 1678 persons (mean age, 50 years) did not receive treatment (control group). Cognitive performance was three times measured during follow-up using the Ruff Figural Fluency Test (RFFT) and Visual Association Test (VAT), and calculated as the average of standardized RFFT and VAT score per participant. Because treatment allocation was nonrandomized, additional analyses were performed in demographic and vascular risk-matched samples and adjusted for propensity scores.
Results:
In the treatment group, mean (SD) cognitive performance changed from - 0.30 (0.80) to - 0.23 (0.80) to 0.02 (0.87), and in control group, from 0.08 (0.77) to 0.24 (0.79) to 0.49 (0.74) at the first, second and third measurement, respectively (ptrend < 0.001). After adjustment for demographics and vascular risk, the change in cognitive performance during follow-up was not statistically significantly different between the treatment and control group: mean estimated difference, - 0.10 (95%CI - 0.21 to 0.01; p = 0.08). Similar results were found in matched samples and after adjustment for propensity score.
Conclusion:
Change in cognitive performance during follow-up was similar in treated and untreated persons. This suggests that lowering vascular risk preserves cognitive performance.
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