The presence of hypertension or diabetes in African American adolescents as young as 12 years old is associated with a higher risk for late-life cognitive decline, new research suggests.
The new analyses were based on data from the Study of Healthy Aging in African Americans (STAR), which included more than 700 participants.
“We want to make sure that efforts to reduce cardiovascular disease risk factors include young people because they may be at high risk for worse cognitive outcomes later in life,” study author Kristen George, PhD, postdoctoral scholar, Whitmer Lab, University of California, Davis.
The results were presented at the Alzheimer’s Association International Conference (AAIC) 2020, held online this year because of the COVID-19 pandemic.
Compared with other ethnic groups, African Americans have been shown to have more cardiovascular disease (CVD) risk factors from adolescence to adulthood, and a higher risk for dementia later in life.
However, it has been unclear whether CVD risk factors that develop prior to midlife are associated with late-life cognition
From 1964 to 1984, Kaiser Permanente Northern California collected information on lifestyle and clinical factors at regular Multiphasic Health Check-ups (MHCs).
During check-ups, researchers collected information on four CVD risk factors:
overweight: body mass index (BMI) ≥ 25 kg/m2;
hypertension: systolic blood pressure ≥ 140 mm/Hg or diastolic ≥ 90 mm/Hg (self-report diagnosis or blood pressure medication);
diabetes: fasting glucose ≥ 120 mg/dL, nonfasting ≥ 200 mg/dL (self-report diagnosis or taking insulin); and
hypercholesterolemia: total cholesterol ≥ 200 mg/dL.
The new analysis from STAR assessed 714 individuals who were long-term members of Kaiser Permanente Northern California. They were recruited into the study at age 50 years and older and had no medical history that would affect cognition.
Investigators divided participants into groups according to age at which CVD risk factor data were measured: adolescents (12-20 years), young adults (21-34 years), and adults (35-56 years).
At baseline, the researchers collected information on education and income, and conducted cognitive assessments. For cognition, verbal episodic memory, semantic memory, and executive function were measured using the Neuropsychological Assessment Scales. The mean age at cognitive assessment was 68 years.
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After adjusting for age, gender, education, and years since risk factors were measured, results showed that both hypertension (pooled β = –0.18) and diabetes (pooled β = –0.69) in adolescence, young adulthood, or mid