Good Cardiovascular Health May Lower the Risk of Cognitive Decline and Dementia in Older Adults

JAMA: The Journal of the American Medical Association

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• This population-based cohort study investigated the association between cardiovascular health and risk of dementia and cognitive decline in individuals ≥65 years of age. The study included 6626 participants and found that optimal cardiovascular metrics measured using a 7-item tool developed by the AHA and a high overall cardiovascular health score were associated with lower risk of cognitive decline and dementia.

• The findings of this study highlight the importance of promoting good cardiovascular health among older adults for prevention of cognitive decline and dementia.

 Primary Care

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Peter Lin MD, CCFP

 Cardiology

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Paul D Thompson MD

Taking Care of Your Heart and Your Head

The American Heart Association (AHA) has developed “AHA's Life’s Simple 7” metrics. These include not smoking, having a body mass index <25, getting regular physical activity, eating fish ≥2 times a week and vegetables ≥2 times a day, and having untreated cholesterol, glucose, and blood pressure values <200 mg/dL, 100 mg/dL, and 120/80 mm Hg, respectively. Hopefully, every cardiologist knows that having a good score on these metrics is associated with a lower risk of cardiovascular disease, but I bet that far fewer cardiologists, including me, know that the Simple 7 are also risk factors for cognitive decline and dementia. Samieri and colleagues examined the AHA's Life Simple 7 in 6626 French citizens. Of the participants, 745 developed dementia over the mean 8.5 years of follow-up. The incidence of dementia was greatest at 1.76/100 person-years among those with 0–1 Simple 7 metrics at baseline, but risk decreased progressively by 0.26, 0.59, 0.43, 0.93, and 0.96 per 100 person-years with the addition of 2, 3, 4, 5, or 6–7 Simple 7 factors, respectively. These results document that healthy lifestyle behaviors are associated with both heart and head health, and suggest that one of the best ways to reduce cognitive decline is to take care of your cardiac risk.