背景:认知功能减退在痴呆发病前可能会持续数十年。更好的心血管健康(CVH)与更少的认知能力下降有关,但目前还不清楚这是否会提前开始,对于所有种族分组,和认知功能的所有领域。这项研究的目的是确定CVH对2个认知领域下降的影响,这些认知领域在中年时首先在白人和黑人女性中下降。
结果:受试者为363名黑人女性和402名白人女性,基线年龄相似(平均值±SD,46.6±3.0年)和教育(15.7±2.0年),来自芝加哥全国妇女健康研究网站。认知,以处理速度和工作内存来衡量,在最多20年内每年或每两年进行评估(平均值±标准差,9.8±6.7年)。CVH被测量为生命必需8(血压,身体质量指数,葡萄糖,非高密度脂蛋白胆固醇,吸烟,身体活动,饮食,sleep).分层线性混合模型确定了认知下降的预测因素,并具有渐进的调整水平。处理速度下降的原因是种族,年龄,和种族的三向互动,CVH,时间(F1,4308=8.8,P=0.003)。CVH与白人女性的下降无关,但在黑人女性中,较贫穷的CVH与更大的下降有关。在整个队列中,工作记忆没有下降,按种族,或通过CVH。
结论:在中年黑人女性中,促进CVH可能是预防认知能力下降的目标,从而提高独立生活与老化。
BACKGROUND: Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife.
RESULTS: Subjects were 363 Black and 402 White women, similar in baseline age (mean±SD, 46.6±3.0 years) and education (15.7±2.0 years), from the Chicago site of the Study of Women\'s Health Across the Nation. Cognition, measured as processing speed and working memory, was assessed annually or biennially over a maximum of 20 years (mean±SD, 9.8±6.7 years). CVH was measured as Life\'s Essential 8 (blood pressure, body mass index, glucose, non-high-density lipoprotein cholesterol, smoking, physical activity, diet, sleep). Hierarchical linear mixed models identified predictors of cognitive decline with progressive levels of adjustment. There was a decline in processing speed that was explained by race, age, and the 3-way interaction of race, CVH, and time (F1,4308=8.8, P=0.003). CVH was unrelated to decline in White women but in Black women poorer CVH was associated with greater decline. Working memory did not decline in the total cohort, by race, or by CVH.
CONCLUSIONS: In midlife Black women, CVH promotion may be a target for preventing the beginnings of cognitive decline, thereby enhancing independent living with aging.