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Association of Cardiovascular Health Level in Older Age With Cognitive Decline and Incident Dementia
| dc.rights.license | open | en_US |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | SAMIERI, Cecilia | |
| dc.contributor.author | PERIER, M. C. | |
| dc.contributor.author | GAYE, B. | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | PROUST LIMA, Cecile
ORCID: 0000-0002-9884-955X IDREF: 114375747 | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | HELMER, Catherine | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | DARTIGUES, Jean-Francois
ORCID: 0000-0001-9482-5529 IDREF: 058586105 | |
| dc.contributor.author | BERR, C. | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | TZOURIO, Christophe
IDREF: 69829209 | |
| dc.contributor.author | EMPANA, J. P. | |
| dc.date.accessioned | 2021-01-04T15:21:46Z | |
| dc.date.available | 2021-01-04T15:21:46Z | |
| dc.date.issued | 2018-08-21 | |
| dc.identifier.issn | 0098-7484 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/23631 | |
| dc.description.abstractEn | Importance: Evidence is limited regarding the relation between cardiovascular health level and dementia risk. Objective: To investigate the association between cardiovascular health level, defined using the 7-item tool from the American Heart Association (AHA), and risk of dementia and cognitive decline in older persons. Design, Setting, and Participants: Population-based cohort study of persons aged 65 years or older from Bordeaux, Dijon, and Montpellier, France, without history of cardiovascular diseases or dementia at baseline who underwent repeated in-person neuropsychological testing (January 1999-July 2016) and systematic detection of incident dementia (date of final follow-up, July 26, 2016). Exposures: The number of the AHA's Life's Simple 7 metrics at recommended optimal level (nonsmoking, body mass index <25, regular physical activity, eating fish twice a week or more and fruits and vegetables at least 3 times a day, cholesterol <200 mg/dL [untreated], fasting glucose <100 mg/dL [untreated], and blood pressure <120/80 mm Hg [untreated]; score range, 0-7) and a global cardiovascular health score (range, 0-14; poor, intermediate, and optimal levels of each metric assigned a value of 0, 1, and 2, respectively). Main Outcomes and Measures: Incident dementia validated by an expert committee and change in a composite score of global cognition (in standard units, with values indicating distance from population means, 0 equal to the mean, and +1 and -1 equal to 1 SD above and below the mean). Results: Among 6626 participants (mean age, 73.7 years; 4200 women [63.4%]), 2412 (36.5%), 3781 (57.1%), and 433 (6.5%) had 0 to 2, 3 to 4, and 5 to 7 health metrics at optimal levels, respectively, at baseline. Over a mean follow-up duration of 8.5 (range, 0.6-16.6) years, 745 participants had incident adjudicated dementia. Compared with the incidence rate of dementia of 1.76 (95% CI, 1.38-2.15) per 100 person-years among those with 0 or 1 health metrics at optimal levels, the absolute differences in incident dementia rates for 2, 3, 4, 5, and 6 to 7 metrics were, respectively, -0.26 (95% CI, -0.48 to -0.04), -0.59 (95% CI, -0.80 to -0.38), -0.43 (95% CI, -0.65 to -0.21), -0.93 (95% CI, -1.18 to -0.68), and -0.96 (95% CI, -1.37 to -0.56) per 100 person-years. In multivariable models, the hazard ratios for dementia were 0.90 (95% CI, 0.84-0.97) per additional optimal metric and 0.92 (95% CI, 0.89-0.96) per additional point on the global score. Furthermore, the gain in global cognition associated with each additional optimal metric at baseline was 0.031 (95% CI, 0.009-0.053) standard units at inclusion, 0.068 (95% CI, 0.045-0.092) units at year 6, and 0.072 (95% CI, 0.042-0.102) units at year 12. Conclusions and Relevance: In this cohort of older adults, increased numbers of optimal cardiovascular health metrics and a higher cardiovascular health score were associated with a lower risk of dementia and lower rates of cognitive decline. These findings may support the promotion of cardiovascular health to prevent risk factors associated with cognitive decline and dementia. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | Biostatistics | |
| dc.subject.en | LEHA | |
| dc.subject.en | SEPIA | |
| dc.subject.en | CIC1401 | |
| dc.subject.en | VINTAGE | |
| dc.title.en | Association of Cardiovascular Health Level in Older Age With Cognitive Decline and Incident Dementia | |
| dc.title.alternative | Jama | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1001/jama.2018.11499 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 30140876 | en_US |
| bordeaux.journal | Jama | en_US |
| bordeaux.page | 657-664 | en_US |
| bordeaux.volume | 320 | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - U1219 | en_US |
| bordeaux.issue | 7 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.team | BIOSTAT_BPH | en_US |
| bordeaux.team | LEHA_BPH | |
| bordeaux.team | SEPIA | en_US |
| bordeaux.team | CIC1401 | en_US |
| bordeaux.team | VINTAGE | en_US |
| bordeaux.team | HEALTHY_BPH | |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.export | false | |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Jama&rft.date=2018-08-21&rft.volume=320&rft.issue=7&rft.spage=657-664&rft.epage=657-664&rft.eissn=0098-7484&rft.issn=0098-7484&rft.au=SAMIERI,%20Cecilia&PERIER,%20M.%20C.&GAYE,%20B.&PROUST%20LIMA,%20Cecile&HELMER,%20Catherine&rft.genre=article |
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