Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
J Alzheimers Dis. 2019;71(3):957-968. doi: 10.3233/JAD-190217.
BACKGROUND/OBJECTIVE: The 2020 Strategic Impact Goal introduced by the American Heart Association (AHA) aims at improving cardiovascular health (CVH) of all Americans by 20%. AHA defined ideal CVH across seven established modifiable risk factors for cardiovascular diseases. Prior studies have indicated that ideal CVH also benefits brain health and cognitive aging, but it is possible that this association is explained by familial factors.
We examined 272 male monozygotic and dizygotic twin pairs (total 544 subjects) free of overt cardiovascular disease and dementia from the Vietnam Era Twin Registry. Memory and learning were measured by Trail Making tests and Wechsler Memory Scale (Immediate and Delayed Memory tests and Visual Reproductive Test). Each of the seven CVH components (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was scored per established criterion.
The mean age of the twins was 55 years, 96% were whites, and 61% monozygotic. When considering twins as individuals, for every unit increase in CVH score (indicating better cardiovascular health), twins demonstrated faster cognitive processing speed (Trail B: - 5.6 s, 95% CI - 10.3, - 0.9; p = 0.03) and better story recall, both immediate (0.35, 95% CI 0.06, 0.62; p = 0.02) and delayed (0.39, 95% CI 0.08, 0.70; p = 0.01).
Better CVH is associated with better cognitive health in several domains. As suggested by within-pair analysis, this association is largely explained by familial factors, implying that early life exposures are shared determinants of both brain health and cardiovascular health.
背景/目的：美国心脏协会（AHA）推出的 2020 年战略影响目标旨在将所有美国人的心血管健康（CVH）提高 20%。AHA 在七个已确立的心血管疾病可改变风险因素的基础上定义了理想的 CVH。先前的研究表明，理想的 CVH 也有益于大脑健康和认知衰老，但这种关联也可能是由家族因素解释的。
我们检查了来自越南时代双胞胎登记处的 272 对男性同卵双胞胎和异卵双胞胎（共 544 人），这些双胞胎没有明显的心血管疾病和痴呆症。记忆和学习通过追踪测试和韦氏记忆量表（即时和延迟记忆测试和视觉再现测试）进行测量。根据既定标准，对 CVH 的七个组成部分（吸烟、体重指数、身体活动、饮食、总胆固醇、血压和血糖）进行评分。
双胞胎的平均年龄为 55 岁，96%为白人，61%为同卵双胞胎。当将双胞胎视为个体时，CVH 评分每增加一个单位（表示心血管健康状况更好），双胞胎的认知处理速度就会更快（轨迹 B：-5.6s，95%CI-10.3，-0.9；p=0.03），故事回忆也更好，即时回忆（0.35，95%CI0.06，0.62；p=0.02）和延迟回忆（0.39，95%CI0.08，0.70；p=0.01）。
更好的 CVH 与多个领域的更好认知健康相关。如对双胞胎内分析所示，这种关联在很大程度上是由家族因素解释的，这意味着早期生活暴露是大脑健康和心血管健康的共同决定因素。
