Cardiovascular health in middle age strongly associated with brain health in later years

Key takeaways:

• Lifestyle habits such as diet and exercise were linked to a higher risk for stroke or dementia later in life.
• More research is needed, including how factors such as race and ethnicity influence the association.

Cardiovascular health of middle-aged adults was significantly associated with the risk of poor brain health later in life, according to a study published in Neurology.

“Brain health is paramount for the optimal well-being of every person, enabling us to function at our highest level and constantly adapt in the world,” Santiago Clocchiatti-Tuozzo, MD, MHS, study author and postdoctoral fellow in geriatric clinical epidemiology and aging-related research in the department of neurology at Yale University, said in a release related to the study.

The American Heart Association’s Life’s Essential 8 (LE8) is a compilation of factors that determine cardiovascular health, although its cumulative effect on metrics related to brain health is unknown. The score encompasses eight modifiable cardiovascular risk factors: blood pressure, glucose, cholesterol, BMI, smoking, physical activity, diet, sleep duration. The factors are organized into 3 subcategories: optimal, intermediate and poor.

Clocchiatti-Tuozzo and colleagues investigated the supposition that worse LE8 profiles in middle-aged adults are associated with higher overall risk of the most relevant clinical factors that contribute to poor brain health.

The researchers engaged in a two-stage prospective study that culled data from the U.K. Biobank (UKB) and All of Us (AoU), the former from the United Kingdom that enrolled more than 500,000 individuals between 2006 and 2010 and the latter an ongoing U.S. cohort study being conducted by the NIH since 2018 with 400,000 people currently enrolled. The discovery stage included 316,127 UKB participants (mean age, 56 years; 52% women), while the replication stage included 68,407 AoU participants (mean age, 56 years; 60% women).

LE8 score was calculated for each individual component, then again for overall score for each participant as an unweighted average of the eight component scores; researchers subsequently divided the overall LE8 scores into three subcategories based on total score (less than 20 meaning poor cardiovascular health; 20 to 80 as intermediate and more than 80 representing optimal cardiovascular health).

The study’s primary outcome was a composite of stroke, dementia or late-life depression, with additional covariate analysis including demographic information collected at each study’s baseline interviews.

According to results, over a mean follow-up time of 4.9 years in the discovery stage, the unadjusted risks for composite outcomes were 0.7% (95% CI 0.61–0.74) for optimal, 1.2% (95% CI 1.11–1.22) for intermediate and 1.8% (95% CI 1.70–1.91) for poor cardiovascular health, respectively.

Data further showed that, over a follow-up of 2.9 years for the replication stage, unadjusted risk of composite outcomes was 2.8% (95% CI 2.49–3.05) for optimal, 6% (95% CI 5.76–6.22) for intermediate and 9.7% (95% CI 9.24–10.24) for poor cardiovascular health.

The association remained in comparative analysis of intermediate vs. optimal cardiovascular health (HR = 1.35; 95% CI, 1.21–1.51) and poor vs. optimal cardiovascular health (HR =1.94; 95% CI, 1.72–2.18).

“Our findings highlight the potential brain health benefits of using these eight cardiovascular and brain health factors to guide healthy lifestyle choices,” Clocchiatti-Tuozzo said in the release. “More research is needed to understand this link between lifestyle habits and brain health, as well as how social factors like race and ethnicity can influence this connection.”

Reference:

Live well, think well: Research shows healthy habits tied to brain health. https://www.aan.com/PressRoom/Home/PressRelease/5208. Published Oct. 24, 2024. Accessed Oct. 28, 2024.