Middle–aged individuals with prevalent cardiovascular disease had more cognitive decline in memory and processing speed compared with healthy controls, while those with incident cardiovascular disease had a more insidious cognitive decline starting at six years after the vascular event, according to a study published July 22 in the European Heart Journal.

In the Maastricht Aging Study (MAAS), a prospective cohort study of determinants of cognitive aging, Syenna H.J. Schievink, MSc, et al., assessed verbal memory, executive function and information processing speed at baseline, six and 12 years in 1,823 participants.

Compared with those without cardiovascular disease, the 195 participants with prevalent CVD were on average older (50.5 vs. 69.5 years), more often smokers, hypertensive (32.2 vs. 80.4 percent), overweight, diabetic (3.4 vs. 10.4 percent), experiencing depressive symptoms (20.8 vs. 21.7 percent) and had a lower educational level. Similarly, the 204 participants with incident CVD were on average older (46.8 vs. 58.8 years), less educated, and more overweight, hypertensive (25.1 vs. 49.1 percent), diabetic (1.5 vs. 7.3 percent) and reported more depressive symptoms (20.5 vs. 21.3 percent).

The results showed that at baseline the cognitive scores were not significantly lower in the individuals with prevalent cardiovascular disease compared with those without cardiovascular disease, but over time they had more decline in verbal memory and information processing speed, suggesting a deviation from age–normal levels. For the individuals with incident cardiovascular disease, there was also a significant decline in verbal memory and information processing speed compared with those without cardiovascular disease, and this became apparent starting at the six–year follow–up and was present at the 12–year follow–up. The authors write that this finding suggests that timely management of cardiovascular disease may delay the onset of cognitive decline.

No differences were found for executive functioning in participants with prevalent or incident cardiovascular disease vs. those without cardiovascular disease.

When the investigators stratified the patients by sex, in participants with prevalent cardiovascular disease the decline in verbal memory appeared to be driven by men and the decline in information processing speed was similar in men and women. Regarding age, the decline in verbal memory and information processing speed was faster in participants with prevalent and incident cardiovascular disease who were younger than in those older than 65 years.

"Our findings were more pronounced in midlife," the study authors write. "This is in line with our previous studies and supports current recommendation to start health and lifestyle interventions aimed at reducing dementia risk in midlife or earlier."