Wallert John, Madison Guy, Held Claes, Olsson Erik
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Psychology, Umeå University, Umeå, Sweden.
Int J Cardiol. 2017 Mar 15;231:13-17. doi: 10.1016/j.ijcard.2016.12.144. Epub 2016 Dec 28.
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.
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/m) 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.
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).
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.
一般认知能力（CA）与后期的身心健康、健康素养和长寿呈正相关。我们调查了在青年期大约30年前评估的CA是否能预测首次心肌梗死（MI）男性患者与生活方式相关的危险因素和两年生存率。
通过对18 - 20岁时进行的心理测量测试估算出的青年期CA，取自义务兵役登记处（INSARK），并与瑞典国家质量登记处SWEDEHEART/RIKS - HIA中60岁及以下首次发生MI的瑞典男性的吸烟、糖尿病、高血压、肥胖（BMI>30kg/m²）数据相链接。在死亡原因登记处对患者进行随访。对5659例完整病例（死亡 = 106例，仍存活 = 5553例）进行描述性比较。采用逻辑回归对粗关联和调整后的关联进行建模。
经过多变量调整后，CA每增加一个标准差，当前吸烟者的比值比降低（0.63 [0.59, 0.67]，P<0.001），既往吸烟者的比值比降低（0.79 [0.73, 0.84]，P<0.001），入院时患糖尿病的比值比降低（0.82 [0.74, 0.90]，P<0.001），肥胖的比值比降低（0.90 [0.84, 0.95]，P<0.001），两年生存率的比值比升高（1.26 [1.02, 1.54]，P<0.001）。CA与入院时的高血压无关（1.03 [0.97, 1.10]，P = 0.283）。
本研究发现青年期CA与中年生活方式危险因素吸烟、糖尿病和肥胖以及首次MI男性患者的两年生存率之间存在显著的负相关。CA评估可能有助于风险分层，并可能有助于进一步定制二级预防策略。
