Introduction
Methods
Participants
Assessment of cardiovascular health
Metrics | Poor (score, 0) | Intermediate (score, 1) | Optimal (score, 2) |
---|---|---|---|
Smoking | Current smoker | Stopped in the last 5 years | Never smoked or stopped > 5 year ago |
Diet | Consumption of fruit and vegetables < 2 times per day AND no consumption of high fibre bread | Consumption of fruit and vegetables ≥ 2 times per day OR consumption of high fibre bread | Consumption of fruit and vegetables ≥ 2 times per day AND consumption of high fibre bread |
Physical activity | Never, < 2–3 times per month, 2–3 times per month in light and/or moderate/intense exercise | Light exercise several times per week or every day | Moderate/intense exercise several times per week or every day |
Body mass index | ≥ 30 kg/m2 | 25−29.9 kg/m2 | < 25 kg/m2 |
Plasma glucose | HbA1c ≥ 6.5% OR self-reported medical history, hypoglycaemic drug use, or diagnosis in the NPR | HbA1c 5.7–6.5% and no diabetes | Hb1Ac < 5.7% |
Total serum cholesterol | ≥ 240 mg/dl | < 200 mg/dl treated OR 200–239 md/dl | < 200 mg/dl untreated |
Systolic and diastolic blood pressure | SBP ≥ 140 mm Hg OR DBP ≥ 90 mm Hg | SBP < 120 mm Hg and DBP < 80 mm Hg treated OR SBP 120–139 OR DBP 80–89 mm Hg | SBP < 120 mm Hg and DBP < 80 mm Hg untreated |
Assessment of cognitive function
Statistical analyses
Results
Worse | Stable | Improved | p value | |
---|---|---|---|---|
Total sample (n = 1022) | ||||
N (%) | 121 (11.8) | 686 (67.1) | 215 (21.0) | |
Age, M (SD) | 66.6 (7.0) | 67.4 (7.2) | 66.9 (7.5) | 0.507 |
Female, N (%) | 74 (61.2) | 411 (59.9) | 133 (61.9) | 0.866 |
Years of education, M (SD) | 13.5 (4.0) | 13.2 (4.1) | 13.4 (3.9) | 0.591 |
MMSE score, M (SD) | 29.5 (0.8) | 29.3 (0.8) | 29.4 (0.8) | 0.192 |
APOE E4 carrier, N (%) | 29 (24.0) | 201 (29.3) | 68 (31.8) | 0.335 |
CVD, N (%) | 13 (10.7) | 76 (11.1) | 19 (8.8) | 0.646 |
LS7, M (SD) | 9.3 (1.8) | 7.8 (1.7) | 6.5 (1.7) | < 0.001 |
BMI poor, N (%) | 10 (8.3) | 91 (13.3) | 38 (17.7) | 0.005 |
smoking poor, N (%) | 13 (10.7) | 77 (11.2) | 50 (23.3) | < 0.001 |
physical activity poor, N (%) | 3 (2.5) | 85 (12.3) | 47 (21.9) | < 0.001 |
cholesterol poor, N (%) | 34 (28.1) | 273 (39.8) | 129 (60.0) | < 0.001 |
glucose poor, N (%) | 5 (4.1) | 39 (5.7) | 14 (6.5) | 0.022 |
blood pressure poor, N (%) | 39 (32.2) | 436 (63.6) | 153 (71.2) | < 0.001 |
diet poor, N (%) | 15 (12.4) | 170 (24.8) | 105 (48.8) | < 0.001 |
new antihypertensive medication at FU, N (%) | 19 (15.7) | 134 (19.5) | 41 (19.1) | 0.612 |
new anticholesterol medication at FU, N (%) | 11 (9.1) | 84 (12.2) | 48 (22.3) | < 0.001 |
Young-old (n = 864) | ||||
N (%) | 103 (11.9) | 579 (67.0) | 182 (21.1) | |
Age, M (SD) | 64.3 (4.5) | 65.0 (4.7) | 64.3 (4.5) | 0.143 |
Female, N (%) | 64 (62.1) | 340 (58.7) | 114 (62.6) | 0.572 |
Years of education, M (SD) | 13.4 (4.1) | 13.4 (4.0) | 13.6 (3.9) | 0.92 |
MMSE score, M (SD) | 29.5 (0.8) | 29.4 (0.8) | 29.5 (0.7) | 0.476 |
APOE E4 carrier, N (%) | 26 (25.2) | 172 (29.7) | 60 (33.1) | 0.402 |
CVD, N (%) | 10 (9.7) | 56 (9.7) | 10 (5.5) | 0.209 |
LS7, M (SD) | 9.2 (1.8) | 7.9 (1.7) | 6.5 (1.8) | < 0.001 |
BMI poor, N (%) | 9 (8.7) | 77 (13.3) | 30 (16.5) | 0.038 |
smoking poor, N (%) | 13 (12.6) | 71 (12.3) | 49 (26.9) | < 0.001 |
physical activity poor, N (%) | 3 (2.9) | 73 (12.6) | 41 (22.5) | < 0.001 |
cholesterol poor, N (%) | 29 (28.2) | 232 (40.1) | 109 (59.9) | < 0.001 |
glucose poor, N (%) | 4 (3.9) | 29 (5.0) | 13 (7.1) | 0.064 |
blood pressure poor, N (%) | 23 (33.0) | 350 (60.4) | 124 (68.1) | < 0.001 |
diet poor, N (%) | 14 (13.6) | 151 (26.1) | 90 (49.5) | < 0.001 |
new antihypertensive medication at FU, N (%) | 13 (12.6) | 109 (18.8) | 34 (18.7) | 0.311 |
new anticholesterol medication at FU, N (%) | 9 (8.7) | 66 (11.4) | 39 (21.4) | 0.001 |
Old-old (n = 158) | ||||
N (%) | 18 (11.4) | 107 (67.7) | 33 (20.9) | |
Age, M (SD) | 79.9 (2.2) | 80.5 (3.1) | 81.4 (3.1) | 0.162 |
Female, N (%) | 10 (55.6) | 71 (66.4) | 19 (57.6) | 0.507 |
Years of education, M (SD) | 14.1 (3.9) | 11.8 (4.0) | 12.4 (3.9) | 0.085 |
MMSE score, M (SD) | 29.3 (0.8) | 28.9 (1.0) | 29.1 (0.9) | 0.299 |
APOE E4 carrier, N (%) | 3 (16.7) | 29 (27.4) | 8 (24.2) | 0.619 |
CVD, N (%) | 3 (16.7) | 20 (18.7) | 9 (27.3) | 0.519 |
LS7, M (SD) | 9.6 (1.5) | 7.6 (1.5) | 6.6 (1.5) | < 0.001 |
BMI poor, N (%) | 1 (5.6) | 14 (13.1) | 8 (24.2) | 0.2 |
smoking poor, N (%) | 0 (0.0) | 6 (5.6) | 1 (3.0) | 0.648 |
physical activity poor, N (%) | 0 (0.0) | 12 (11.2) | 6 (18.2) | 0.145 |
cholesterol poor, N (%) | 5 (27.8) | 41 (38.3) | 20 (60.6) | 0.019 |
glucose poor, N (%) | 1 (5.6) | 10 (9.3) | 1 (3.0) | 0.208 |
blood pressure poor, N (%) | 5 (27.8) | 86 (80.4) | 29 (87.9) | < 0.001 |
diet poor, N (%) | 1 (5.6) | 19 (17.8) | 15 (45.5) | 0.004 |
new antihypertensive medication at FU, N (%) | 6 (33.3) | 25 (23.4) | 7 (21.2) | 0.6 |
new anticholesterol medication at FU, N (%) | 2 (11.1) | 18 (16.8) | 9 (27.3) | 0.28 |
Cognitive test | Worse | Improved | ||||
---|---|---|---|---|---|---|
Beta | P value | 95% CI | Beta | P value | 95% CI | |
Total Sample | ||||||
episodic memory | −0.02* | 0.005 | −0.04, −0.01 | −0.02* | 0.004 | −0.03, −0.01 |
semantic memory | −0.01 | 0.275 | −0.02, 0.01 | −0.01 | 0.333 | −0.02, 0.01 |
verbal fluency | −0.01 | 0.014 | −0.02, 0.00 | −0.01 | 0.055 | −0.02, 0.00 |
perceptual speed | 0.00 | 0.964 | −0.01, 0.01 | 0.00 | 0.535 | −0.01, 0.01 |
global cognition | −0.01* | 0.024 | −0.02, 0.00 | −0.01* | 0.016 | −0.02, 0.00 |
Young-old | ||||||
episodic memory | −0.02 | 0.088 | −0.03, 0.00 | −0.02 | 0.024 | −0.03, 0.00 |
semantic memory | 0.00 | 0.996 | −0.01, 0.01 | −0.01 | 0.332 | −0.02, 0.01 |
verbal fluency | −0.01 | 0.153 | −0.02, 0.00 | −0.01 | 0.083 | −0.02, 0.00 |
perceptual speed | 0.01 | 0.052 | 0.00, 0.03 | 0.00 | 0.682 | −0.01, 0.01 |
global cognition | 0.00 | 0.590 | −0.01, 0.01 | −0.01* | 0.025 | −0.02, 0.00 |
Old-old | ||||||
episodic memory | −0.05* | 0.002 | −0.09, −0.02 | −0.02 | 0.258 | −0.04, 0.01 |
semantic memory | −0.05 | 0.046 | −0.10, 0.00 | 0.00 | 0.967 | −0.04, 0.04 |
verbal fluency | −0.05* | 0.005 | −0.08, −0.01 | −0.01 | 0.419 | −0.04, 0.02 |
perceptual speed | −0.09* | 0.000 | −0.13, −0.05 | −0.01 | 0.688 | −0.04, 0.02 |
global cognition | −0.06* | 0.000 | −0.08, −0.03 | −0.01 | 0.423 | −0.03, 0.01 |
Cognitive test | Worse | Improved | ||||
---|---|---|---|---|---|---|
Beta | P value | 95% CI | Beta | P value | 95% CI | |
Smoking | ||||||
episodic memory | −0.10 | 0.142 | −0.24, 0.03 | 0.01 | 0.676 | −0.05, 0.07 |
semantic memory | 0.07 | 0.557 | −0.17, 0.32 | −0.02 | 0.723 | −0.10, 0.07 |
verbal fluency | −0.16 | 0.016 | −0.29, −0.03 | 0.00 | 0.882 | −0.07, 0.06 |
perceptual speed | −0.19 | 0.014 | −0.34, −0.04 | 0.00 | 0.947 | −0.07, 0.08 |
global cognition | −0.14* | 0.010 | −0.24, −0.03 | 0.00 | 0.892 | −0.05, 0.05 |
Diet | ||||||
episodic memory | −0.01 | 0.579 | −0.04, 0.02 | −0.01 | 0.644 | −0.03, 0.02 |
semantic memory | −0.02 | 0.481 | −0.07, 0.03 | 0.04 | 0.078 | 0.00, 0.08 |
verbal fluency | −0.01 | 0.455 | −0.05, 0.02 | −0.01 | 0.722 | −0.03, 0.02 |
perceptual speed | 0.01 | 0.764 | −0.04, 0.05 | 0.01 | 0.711 | −0.03, 0.04 |
global cognition | 0.00 | 0.813 | −0.03, 0.02 | 0.01 | 0.408 | −0.01, 0.03 |
Physical activity | ||||||
episodic memory | −0.02 | 0.131 | −0.05, 0.01 | 0.02 | 0.303 | −0.02, 0.05 |
semantic memory | −0.04 | 0.044 | −0.08, 0.00 | −0.03 | 0.183 | −0.08, 0.02 |
verbal fluency | −0.02 | 0.174 | −0.05, 0.01 | −0.01 | 0.417 | −0.05, 0.02 |
perceptual speed | −0.05* | 0.005 | −0.08, −0.01 | −0.02 | 0.234 | −0.07, 0.02 |
global cognition | −0.03* | 0.001 | −0.06, −0.01 | −0.01 | 0.310 | −0.04, 0.01 |
Body mass index | ||||||
episodic memory | −0.03 | 0.180 | −0.06, 0.01 | −0.03 | 0.067 | −0.06, 0.00 |
semantic memory | 0.02 | 0.423 | −0.03, 0.08 | 0.01 | 0.643 | −0.04, 0.06 |
verbal fluency | 0.01 | 0.791 | −0.03, 0.05 | −0.02 | 0.297 | −0.05, 0.01 |
perceptual speed | −0.02 | 0.516 | −0.06, 0.03 | 0.02 | 0.250 | −0.02, 0.06 |
global cognition | 0.00 | 0.821 | −0.04, 0.03 | 0.00 | 0.788 | −0.03, 0.02 |
Blood glucose | ||||||
episodic memory | 0.00 | 0.705 | −0.02, 0.03 | −0.01 | 0.664 | −0.05, 0.03 |
semantic memory | −0.02 | 0.410 | −0.05, 0.02 | −0.01 | 0.852 | −0.06, 0.05 |
verbal fluency | 0.02 | 0.104 | 0.00, 0.05 | 0.02 | 0.336 | −0.02, 0.06 |
perceptual speed | 0.00 | 0.985 | −0.03, 0.03 | 0.01 | 0.606 | −0.04, 0.06 |
global cognition | 0.01 | 0.514 | −0.01, 0.03 | 0.01 | 0.737 | −0.03, 0.04 |
Total cholesterol | ||||||
episodic memory | 0.00 | 0.955 | −0.04, 0.04 | −0.02 | 0.195 | −0.04, 0.01 |
semantic memory | −0.01 | 0.766 | −0.06, 0.05 | −0.01 | 0.445 | −0.05, 0.02 |
verbal fluency | −0.02 | 0.292 | −0.06, 0.02 | 0.01 | 0.488 | −0.02, 0.03 |
perceptual speed | −0.04 | 0.096 | −0.09, 0.01 | 0.01 | 0.481 | −0.02, 0.04 |
global cognition | −0.01 | 0.517 | −0.04, 0.02 | 0.00 | 0.846 | −0.02, 0.02 |
Blood pressure | ||||||
episodic memory | −0.05* | 0.002 | −0.08, −0.02 | −0.01 | 0.524 | −0.03, 0.02 |
semantic memory | −0.03 | 0.152 | −0.08, 0.01 | 0.01 | 0.462 | −0.02, 0.05 |
verbal fluency | −0.03 | 0.036 | −0.07, 0.00 | −0.01 | 0.455 | −0.04, 0.02 |
perceptual speed | −0.04 | 0.032 | −0.08, 0.00 | 0.00 | 0.987 | −0.03, 0.03 |
global cognition | −0.04* | 0.005 | −0.06, −0.01 | 0.00 | 0.872 | −0.02, 0.02 |