Author(s): Schubert CR, Cruickshanks KJ, Fischer ME, Pinto AA, Chen Y, Huang GH, Klein BEK,Klein R, Pankow JS, Paulsen AJ, Dalton DS, Tweed TS. Sensorineural Impairments, Cardiovascular Risk Factors, and 10-Year Incidence of Cognitive Impairment and Decline in Midlife: The Beaver Dam Offspring Study. J Gerontol A Biol Sci Med Sci. 2019 Jan 9. doi: 10.1093/gerona/glz011. [Epub ahead of print]
Journal: The Journals Of Gerontology. Series A, Biological Sciences And Medical Sciences, Jan 2019
Background Sensorineural impairments and cardiovascular risk factors (CVRF) and disease (CVD) in midlife may be important predictors of future cognitive health but longitudinal studies that include multiple sensorineural measures in middle-aged adults are lacking.
Methods Hearing, vision and olfaction, CVRF and CVD were measured at the Beaver Dam Offspring Study baseline (2005-2008) examination. The Mini-Mental State Examination and Trail Making Tests A and B were administered at all phases and additional cognitive function measures were obtained at 5 (2010-2013) and 10 years (2015-2017). Cox proportional hazards models were used to evaluate associations between baseline sensorineural impairments, CVRF, CVD and 10-year cumulative incidence of cognitive impairment and decline.
Results There were 2556 participants (22-84 years) without cognitive impairment at baseline and data from at least one follow-up. In a multivariable model including age, sex, education and head injury, visual impairment (Hazard Ratio (HR) = 2.59, 95% Confidence Interval (CI)=1.34, 5.02), olfactory impairment (HR=3.18, 95% CI=1.53, 6.59), CVD (HR=2.37, 95% CI=1.24, 4.52) and not consuming alcohol in the past year(HR=2.21, 95% CI = 1.16, 4.19) were associated with the 10-year cumulative incidence of cognitive impairment. Current smoking and diabetes were associated with increased risk, and exercise decreased risk, of 10-year decline in cognitive function.
Conclusions Visual and olfactory impairments, CVRF and CVD were associated with the 10-year cumulative incidence of cognitive impairment and decline in middle-aged adults. Identifying modifiable factors associated with cognitive decline and impairment in midlife may provide opportunities for prevention or treatment and improve cognitive health later in life.