Research Centre of Applied and Preventive Cardiovascular Medicine (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku, Finland.
Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health (J.O.H., K.P.), University of Turku, Finland.
Circulation. 2021 May 18;143(20):1949-1961. doi: 10.1161/CIRCULATIONAHA.120.052358. Epub 2021 May 10.
Cardiovascular risk factors, such as high blood pressure, adverse serum lipids, and elevated body mass index in midlife, may harm cognitive performance. It is important to note that longitudinal accumulation of cardiovascular risk factors since childhood may be associated with cognitive performance already since childhood, but the previous evidence is scarce. We studied the associations of cardiovascular risk factors from childhood to midlife, their accumulation, and midlife cognitive performance.
From 1980, a population-based cohort of 3596 children (3-18 years of age) have been repeatedly followed up for 31 years. Blood pressure, serum lipids, and body mass index were assessed in all follow-ups. Cardiovascular risk factor trajectories from childhood to midlife were identified using latent class growth mixture modeling. Cognitive testing was performed in 2026 participants 34 to 49 years of age using a computerized test. The associations of the cardiovascular risk factor trajectories and cognitive performance were studied for individual cardiovascular risk factors and cardiovascular risk factor accumulation.
Consistently high systolic blood pressure (β=-0.262 SD [95% CI, -0.520 to -0.005]) and serum total cholesterol (β=-0.214 SD [95% CI, -0.365 to -0.064]) were associated with worse midlife episodic memory and associative learning compared with consistently low values. Obesity since childhood was associated with worse visual processing and sustained attention (β=-0.407 SD [95% CI, -0.708 to -0.105]) compared with normal weight. An inverse association was observed for the cardiovascular risk factor accumulation with episodic memory and associative learning ( for trend=0.008; 3 cardiovascular risk factors: β=-0.390 SD [95% CI, -0.691 to -0.088]), with visual processing and sustained attention ( for trend<0.0001; 3 cardiovascular risk factors: β=-0.443 SD [95% CI, -0.730 to -0.157]), and with reaction and movement time ( for trend=0.048; 2 cardiovascular risk factors: β=-0.164 SD [95% CI, -0.318 to -0.010]).
Longitudinal elevated systolic blood pressure, high serum total cholesterol, and obesity from childhood to midlife were inversely associated with midlife cognitive performance. It is important to note that the higher the number of cardiovascular risk factors, the worse was the observed cognitive performance. Therefore, launching preventive strategies against cardiovascular risk factors beginning from childhood might benefit primordial promotion of cognitive health in adulthood.
心血管危险因素，如中年时的高血压、不良血清脂质和体重指数升高，可能会损害认知表现。值得注意的是，自儿童期起纵向累积的心血管危险因素可能与儿童期的认知表现有关，但先前的证据很少。我们研究了从儿童期到中年期的心血管危险因素的相关性、它们的累积以及中年期的认知表现。
自 1980 年以来，一项基于人群的队列研究纳入了 3596 名儿童（3-18 岁），并对他们进行了长达 31 年的随访。在所有随访中都评估了血压、血清脂质和体重指数。使用潜在类别增长混合模型来确定从儿童期到中年期的心血管危险因素轨迹。在 2026 名 34 至 49 岁的参与者中使用计算机化测试进行认知测试。研究了心血管危险因素轨迹和认知表现之间的个体心血管危险因素和心血管危险因素积累的相关性。
持续升高的收缩压（β=-0.262 SD [95% CI，-0.520 至 -0.005]）和血清总胆固醇（β=-0.214 SD [95% CI，-0.365 至 -0.064]）与中年期情景记忆和联想学习较差相关，而持续较低的收缩压和血清总胆固醇水平则与之相反。与正常体重相比，儿童期肥胖与视觉处理和持续注意力较差有关（β=-0.407 SD [95% CI，-0.708 至 -0.105]）。与情景记忆和联想学习（ for trend=0.008；3 个心血管危险因素：β=-0.390 SD [95% CI，-0.691 至 -0.088]）、视觉处理和持续注意力（ for trend<0.0001；3 个心血管危险因素：β=-0.443 SD [95% CI，-0.730 至 -0.157]）和反应和运动时间（ for trend=0.048；2 个心血管危险因素：β=-0.164 SD [95% CI，-0.318 至 -0.010]）呈负相关。
自儿童期到中年期的纵向升高的收缩压、高血清总胆固醇和肥胖与中年期认知表现呈负相关。值得注意的是，心血管危险因素数量越多，观察到的认知表现越差。因此，从儿童期开始实施针对心血管危险因素的预防策略可能有助于促进成年期的认知健康。
