Midlife cardiovascular risk factors and late cognitive impairment
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Cardiovascular risk factors increase the risk of dementia in later life. The aims of the current study were to assess the effect of multiple midlife cardiovascular risk factors on the risk of cognitive impairment in later life, and to assess the validity of the previously suggested CAIDE Study risk score predicting dementia risk 20 years later. A total of 2,165 Finnish twins were followed and at the end of the follow-up their cognitive status was assessed with a validated telephone interview. The assessment of the risk factors at baseline was based on a self-report questionnaire. Relative risk ratios (RR) were calculated and receiver operating characteristic analyses performed. Midlife obesity (RR 2.42, 95 % CI 1.47–3.98), hypertension (RR 1.38, 95 % CI 1.01–1.88) and low leisure time physical activity (RR 2.52, 95 % CI 1.10–5.76) increased the risk of cognitive impairment after a mean follow-up of 22.6 ± 2.3 years. Hypercholesterolemia did not significantly increase the risk (RR 1.52, 95 % CI 0.92–2.51). Overweight individuals who gained more than 10 % weight between 1981 and 1990 had an increased risk of cognitive impairment (RR 4.27, 95 % CI 1.62–11.2). The CAIDE Study risk score combining various individual risk factors had an area-under-curve of 0.74 (95 % CI 0.69–0.79, n = 591), and there was a strong association between an increasing risk score and the risk of cognitive impairment. The results indicate that multiple midlife cardiovascular risk factors increase the risk of cognitive impairment in later life. Also, a risk score including easily measurable midlife factors predicts an individual’s cognitive impairment risk well.
KeywordsAll cognitive disorders/dementia Alzheimer’s disease Risk factors in epidemiology Cohort studies
Finnish Cardiovascular Risk Factors, Aging and Dementia study
Mild impairment in cognitive function
Body mass index
Relative risk ratio
- 95 % CI
95 % confidence interval
Events per variable
Receiver operating characteristic
The skilful assistance of research nurses Ulla Kulmala-Gråhn, Maarit Mantere and Kristiina Saanakorpi in interviewing the subjects is gratefully acknowledged. The assistance of Maarit Lappalainen at FIMM with ApoE genotyping is acknowledged. This study was financially supported by the Academy of Finland (project #205954), the Sigrid Juselius Foundation and Clinical grants of Turku University Hospital (EVO). The Finnish Twin Cohort study is part of the Academy of Finland Center of Excellence in Complex Disease Genetics (grant #s 213506, 129680).
Conflict of interest
The authors declare that they have no conflict of interest.
- 22.World Health Organization. Global Database on Body Mass Index: BMI classification. 2011;2011.Google Scholar
- 27.Farrer LA, Cupples LA, Haines JL, Hyman B, Kukull WA, Mayeux R, et al. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. JAMA. 1997;278:1349–56.CrossRefPubMedGoogle Scholar
- 28.SNPedia. ApoE. 2011;2011.Google Scholar
- 30.UCLA: Academic Technology Services, statistical consulting group. Stata FAQ: How do I use xi3?;2011.Google Scholar
- 32.Glaziou P. Sampsize home page. 2005;2011.Google Scholar
- 35.Laitala VS, Kaprio J, Koskenvuo M, Raiha I, Rinne JO, Silventoinen K. Association and causal relationship of midlife obesity and related metabolic disorders with old age cognition. Curr Alzheimer Res 2011:699–706.Google Scholar
- 45.Kaprio J, Silventoinen K. Advanced methods in Twin studies. In: (ed), Genetic Epidemiology. New York, USA: Humana Press, c/o Springer Science + Business Media, 2011:143–152.Google Scholar