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Hypothetical Interventions on Cardiovascular Health Metrics for Abnormal Cognitive Aging: An Application of the
1Xiaozhen Lv, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), 51 Huayuan North Road, Haidian District, Beijing 100191, China,
Insights
Improving cardiovascular health through exercise, diet, and maintaining a healthy body mass index (BMI) can significantly reduce the risk of abnormal cognitive aging in older adults. These lifestyle interventions offer practical strategies for cognitive health preservation.
Area of Science:
- Gerontology
- Cognitive Neuroscience
- Public Health
Background:
- Abnormal cognitive aging is a significant precursor to dementia.
- Understanding factors influencing cognitive aging is crucial for preventative strategies.
Purpose of the Study:
- To investigate the impact of cardiovascular health (CVH) metrics on abnormal cognitive aging.
- To identify specific CVH metrics and their combinations that influence cognitive trajectories over time.
Main Methods:
- A longitudinal cohort study involving 3298 older adults (≥65 years) from the Chinese Longitudinal Health Longevity Survey.
- Cognitive performance assessed using the Mini-Mental State Examination (MMSE); CVH assessed via hypertension, diabetes, exercise, BMI, diet, and smoking.
- Group-based trajectory modeling and parametric g-formula used to analyze 12-year cognitive aging patterns and the effects of CVH interventions.
Main Results:
- Four cognitive aging trajectories identified: Stable-high (77.4%), Unstable (4.9%), Slow decline (11.1%), and Rapid decline (6.6%).
- Abnormal cognitive aging (Unstable, Slow, Rapid decline) affected 22.6% of participants.
- Interventions targeting hypertension, exercise, BMI, and diet showed potential to reduce abnormal cognitive aging risk; combined interventions on exercise, BMI, and diet yielded substantial risk reductions (RR 0.30-0.45).
Conclusions:
- A significant portion of older adults experience abnormal cognitive aging.
- Modifiable cardiovascular health metrics, particularly exercise, BMI, and diet, represent effective and feasible targets for preventing abnormal cognitive aging.
- Public health initiatives should promote these lifestyle interventions to support cognitive health in aging populations.
Background:
Abnormal cognitive aging is closely related to dementia.
Objectives:
This study aimed to estimate the effect of cardiovascular health (CVH) metrics on abnormal cognitive aging.
Design:
A longitudinal cohort study.
Setting:
Participants were recruited from the Chinese Longitudinal Health Longevity Survey.
Participants:
A total of 3298 participants aged ≥65 years with normal cognitive performance at baseline were included.
Measurements:
Cognitive performance was measured by the Chinese version of the Mini-Mental State Examination (MMSE). CVH was assessed with six metrics, including hypertension, diabetes, exercise, body mass index (BMI), diet, and smoking. Group-based trajectory model was used to identify the trajectory groups of cognitive aging over 12 years (2002-2014 and 2005-2018). The parametric g-formula was applied to estimate the effect of each single six CVH metrics and their combinations on the 12-year cognitive aging trajectory.
Results:
Four trajectory groups of cognitive aging were identified: Stable-high (77.4%), Unstable (4.9%), Slow decline (11.1%), and Rapid decline (6.6%). Unstable, Slow decline, and Rapid decline trajectory groups were considered as abnormal cognitive aging (22.6%). Single interventions on hypertension, exercise, BMI, and diet could reduce the risk of abnormal cognitive aging. Moreover, the risk ratios of joint intervention on exercise, BMI, and diet for Unstable, Slow decline, and Rapid decline trajectory groups were 0.38 (95% CI: 0.30-0.48), 0.45 (95% CI: 0.37-0.54), and 0.3 (95% CI: 0.23-0.41), respectively.
Conclusion:
A considerable proportion of the participants experienced abnormal cognitive aging during their aging process. Interventions on these CVH metrics (i.e., exercise, BMI, and diet), which are fairly practical and feasible for older adults, may be effective strategies for preventing abnormal cognitive aging.
