Life’s Simple 7’s Cardiovascular Health Metrics are Associated with Hispanic/Latino Neurocognitive Function: HCHS/SOL Results

Article type: Research Article

Authors: González, Hector M.^{a; *} | Tarraf, Wassim^b | Gouskova, Natalia^c | Rodríguez, Carlos J.^d | Rundek, Tatjana^e | Grober, Ellen^f | Pirzada, Amber^g | González, Patricia^h | Lutsey, Pamela L.ⁱ | Camacho, Alvaro^j | Daviglus, Martha L.^g | Wright, Clinton^e | Mosley, Thomas H.^k

Affiliations: [a] Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA | [b] Institute of Gerontology and the Department of Health Care Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA | [c] UNC Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA | [d] Public Heath Sciences, Wake Forest University, Winston-Salem, NC, USA | [e] Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA | [f] The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA | [g] Institute for Minority Health Research, College of Medicine at Chicago, University of Illinois at Chicago, Chicago, IL, USA | [h] Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA | [i] Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA | [j] Departments of Psychiatry, Family Medicine, and Public Health, University of California at San Diego, San Diego, CA, University of California, San Diego School of Medicine, La Jolla, CA, USA | [k] Department of Medicine (Geriatrics) and Neurology, University of Mississippi Medical Center, Jackson, MS, USA

Correspondence: [*] Correspondence to: Hector M. González, PhD, Epidemiology and Biostatistics, Michigan State University, 909 Fee Road, East Lansing, MI 48824, USA. Tel.: +1 517 884 6628; Fax: +1 517 432 1130; E-mail: hmgonzalez@epi.msu.edu.

Abstract: Background: Hispanics/Latinos are purportedly at increased risk for neurocognitive decline and dementias. Without dementia cures, low-cost, well-tolerated public health means for mitigating neurocognitive decline are needed. Objective: We examined associations between neurocognition and cardiovascular health (CVH) metrics (Life’s Simple 7; LS7) among diverse Hispanics/Latinos. We hypothesized that higher LS7 would be associated with healthier brain function (neurocognitive performance). Methods: We used baseline (2008–2011) Hispanic Community Health Study/Study of Latinos (HCHS/SOL; N = 9,623; ages 45–74 years) to examine neurocognition in relation to CVH LS7 scores. Results: In age and sex adjusted models, a one unit LS7 score increase (range = 0–14) was associated with higher neurocognitive function on the B-SEVLT sum (0.23 [p < 0.01]; range = 3–42), B-SEVLT recall (0.12 [p < 0.01]; range = 0–15), Word Fluency (phonemic; 0.46 (p < 0.01); range = 0–49), and Digit Symbol Substitution (0.49 (p < 0.01); range = 0–83) tests, respectively. Stated differently, a change from the minimum LS7 (0) to maximum LS7 (14) score corresponded to higher scores on verbal learning (4.62) and memory (2.24), verbal fluency (7.0), and psychomotor processing speed (12). In fully adjusted models the associations were attenuated, but remained statistically significant. Incremental adjustments indicated that Latino background and, to a lesser extent, education were primary contributors to the evinced attenuations. Conclusions: We found that higher neurocognitive function was associated with better LS7 CVH metrics among middle-aged and older Hispanics/Latinos. Associations between neurocognitive function and LS7 were strongest among two at-risk groups for neurocognitive decline and dementia, women and Hispanics/Latinos with lower education. Public health efforts to reduce cardiovascular disease morbidity and mortality may have additional neurocognitive benefits among at-risk Hispanics/Latinos.

Keywords: Cardiovascular system, cognition, epidemiology, Hispanic Americans

DOI: 10.3233/JAD-151125

Journal: Journal of Alzheimer's Disease, vol. 53, no. 3, pp. 955-965, 2016