Skip to main content
Top
Published in: Annals of Behavioral Medicine 3/2015

01-06-2015 | Original Article

Composite Cardiovascular Risk Scores and Neuropsychological Functioning: A Meta-Analytic Review

Authors: Jonathan DeRight, Ph.D., Randall S. Jorgensen, Ph.D., Misaell J. Cabral, B.S.

Published in: Annals of Behavioral Medicine | Issue 3/2015

Login to get access

Abstract

Background

The ability for patients to understand their risk for disease is important to early intervention and effective treatment. The link between individual cardiovascular risk factors and cognition has been well-established.

Purpose

This study investigated the relationship between cognition and a combination of these factors through a single composite risk score.

Methods

This study quantitatively summarized the strength of the association between composite cardiovascular risk scores and cognitive test performance using meta-analytic methods.

Results

One hundred and nine effect sizes were obtained from 19 studies employing 54,564 participants. Composite risk scores showed a significant association (r = −0.16) with cognitive test performance. Cognitive domain and age did not significantly modify this relationship.

Conclusions

Composite cardiovascular risk scores can be useful indicators of future cognition. The development of a dementia risk score using similar risk factors could aid in the assessment and lifestyle interventions of persons at risk for dementia.
Literature
2.
go back to reference Centers for Disease Control. Summary health statistics for U.S. Adults: National Health Interview Survey, 2010. Vital and Health Statistics, Series 10, 2012; (Number 252). Centers for Disease Control. Summary health statistics for U.S. Adults: National Health Interview Survey, 2010. Vital and Health Statistics, Series 10, 2012; (Number 252).
6.
go back to reference * Laughlin GA, McEvoy LK, von Mühlen D, et al. Sex differences in the association of Framingham Cardiac Risk Score with cognitive decline in community-dwelling elders without clinical heart disease. Psychosom Med. 2011; 73: 683-689. doi:10.1097/PSY.0b013e31822f9089. * Laughlin GA, McEvoy LK, von Mühlen D, et al. Sex differences in the association of Framingham Cardiac Risk Score with cognitive decline in community-dwelling elders without clinical heart disease. Psychosom Med. 2011; 73: 683-689. doi:10.​1097/​PSY.​0b013e31822f9089​.
9.
go back to reference * Kaffashian S, Dugravot A, Nabi H, Batty GD, Brunner E, Kivimäki M, Singh-Manoux A. Predictive utility of the Framingham general cardiovascular disease risk profile for cognitive function: Evidence from the Whitehall II study. Eur Heart J. 2011; 32: 2326–2332. doi: 10.1093/eurheartj/ehr122. * Kaffashian S, Dugravot A, Nabi H, Batty GD, Brunner E, Kivimäki M, Singh-Manoux A. Predictive utility of the Framingham general cardiovascular disease risk profile for cognitive function: Evidence from the Whitehall II study. Eur Heart J. 2011; 32: 2326–2332. doi: 10.​1093/​eurheartj/​ehr122.
12.
go back to reference Debette S, Seshadri S, Beiser A, et al. Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline. Neurology. 2011; 77: 461-468.CrossRefPubMedCentralPubMed Debette S, Seshadri S, Beiser A, et al. Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline. Neurology. 2011; 77: 461-468.CrossRefPubMedCentralPubMed
13.
go back to reference Ciobica A, Padurariu M, Bild W, et al. Cardiovascular risk factors as potential markers for mild cognitive impairment and Alzheimer’s disease. Psychiatr Danub. 2011; 23(4): 340-346.PubMed Ciobica A, Padurariu M, Bild W, et al. Cardiovascular risk factors as potential markers for mild cognitive impairment and Alzheimer’s disease. Psychiatr Danub. 2011; 23(4): 340-346.PubMed
14.
go back to reference Seshadri S, Wolf PA, Beiser A, et al. Stroke risk profile, brain volume, and cognitive function: The Framingham offspring study. Neurology. 2004; 63: 1591-1599.CrossRefPubMed Seshadri S, Wolf PA, Beiser A, et al. Stroke risk profile, brain volume, and cognitive function: The Framingham offspring study. Neurology. 2004; 63: 1591-1599.CrossRefPubMed
16.
go back to reference * Llewellyn DJ, Lang IA, Xie J, Huppert FA, Melzer D, Langa KM. Framingham Stroke Risk Profile and poor cognitive function: A population-based study. BMC Neurol. 2008; 8 (12). doi:10.1186/147-2377-8-12 * Llewellyn DJ, Lang IA, Xie J, Huppert FA, Melzer D, Langa KM. Framingham Stroke Risk Profile and poor cognitive function: A population-based study. BMC Neurol. 2008; 8 (12). doi:10.​1186/​147-2377-8-12
17.
go back to reference Li J, Wang YJ, Zhang M, et al. Vascular risk factors promote conversion from mild cognitive impairment to Alzheimer disease. Neurology. 2011; 76: 1485-1491.CrossRefPubMed Li J, Wang YJ, Zhang M, et al. Vascular risk factors promote conversion from mild cognitive impairment to Alzheimer disease. Neurology. 2011; 76: 1485-1491.CrossRefPubMed
19.
go back to reference Kivipelto M, Helkala EL, Hänninen T, et al. Midlife vascular risk factors and late-life mild cognitive impairment: A population-based study. Neurology. 2001; 56: 1683-1689.CrossRefPubMed Kivipelto M, Helkala EL, Hänninen T, et al. Midlife vascular risk factors and late-life mild cognitive impairment: A population-based study. Neurology. 2001; 56: 1683-1689.CrossRefPubMed
20.
go back to reference Seux ML, Thijs L, Forette F, et al. Correlates of cognitive status of old patients with isolated systolic hypertension: the Syt-Eur vascular Demenia project. J Hypertens. 1998; 16: 963-969.CrossRefPubMed Seux ML, Thijs L, Forette F, et al. Correlates of cognitive status of old patients with isolated systolic hypertension: the Syt-Eur vascular Demenia project. J Hypertens. 1998; 16: 963-969.CrossRefPubMed
21.
go back to reference Farmer ME, White LR, Abbott RD, et al. Blood pressure and cognitive performance. The Framingham study. Am J Epidemiol. 1987; 126(6): 1103-1114.PubMed Farmer ME, White LR, Abbott RD, et al. Blood pressure and cognitive performance. The Framingham study. Am J Epidemiol. 1987; 126(6): 1103-1114.PubMed
22.
23.
go back to reference * Zade D, Beiser A, McGlinchey R, Au R, Seshadri S, Palumbo C, Wolf PA, DeCarli C, Milberg W. Interactive Effects of Apolipoprotein E Type 4 Genotype and Cerebrovascular Risk on Neuropsychological Performance and Structural Brain Changes. J Stroke Cerebrovasc Dis. 2010; 19 (4):261–268. doi:10.1016/j.jstrokecerebrovasdis.2009.05.001 * Zade D, Beiser A, McGlinchey R, Au R, Seshadri S, Palumbo C, Wolf PA, DeCarli C, Milberg W. Interactive Effects of Apolipoprotein E Type 4 Genotype and Cerebrovascular Risk on Neuropsychological Performance and Structural Brain Changes. J Stroke Cerebrovasc Dis. 2010; 19 (4):261–268. doi:10.1016/j.jstrokecerebrovasdis.2009.05.001
25.
go back to reference Knopman D, Boland LL, Mosley T, et al. Atherosclerosis risk in communities (ARIC) study investigators. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology. 2001; 56: 42-48.CrossRefPubMed Knopman D, Boland LL, Mosley T, et al. Atherosclerosis risk in communities (ARIC) study investigators. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology. 2001; 56: 42-48.CrossRefPubMed
27.
go back to reference Maineri NL, Xavier FM, Berleze MC, et al. Risk factors for cerebrovascular disease and cognitive function in the elderly. Arq Bras Cardiol. 2007; 89(3): 142-146.CrossRef Maineri NL, Xavier FM, Berleze MC, et al. Risk factors for cerebrovascular disease and cognitive function in the elderly. Arq Bras Cardiol. 2007; 89(3): 142-146.CrossRef
29.
go back to reference Wadley VG, McClure LA, Howard VJ, et al. Cognitive status, stroke symptom reports, and modifiable risk factors among individuals with no diagnosis of stroke or transient ischemic attack in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Stroke. 2007; 38: 1143-1147. doi:10.1161/01.STR.0000259676.75552.38.CrossRefPubMed Wadley VG, McClure LA, Howard VJ, et al. Cognitive status, stroke symptom reports, and modifiable risk factors among individuals with no diagnosis of stroke or transient ischemic attack in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Stroke. 2007; 38: 1143-1147. doi:10.​1161/​01.​STR.​0000259676.​75552.​38.CrossRefPubMed
30.
go back to reference Starr JM, Deary IJ, Inch S, et al. Age-associated cognitive decline in healthy old people. Age Ageing. 1997; 26: 295-300.CrossRefPubMed Starr JM, Deary IJ, Inch S, et al. Age-associated cognitive decline in healthy old people. Age Ageing. 1997; 26: 295-300.CrossRefPubMed
32.
go back to reference * Smith PJ, Blumenthal JA, Babyak MA, Benson MH, Doraiswamy M, Waugh R, Hinderliter A, Sherwood A. Cerebrovascular risk factors, vascular disease, and neuropsychological outcomes in adults with major depression. Psychosom Med. 2007; 69 (6):578–586. doi:10.1097/PSY.0b013e31812f7b8e * Smith PJ, Blumenthal JA, Babyak MA, Benson MH, Doraiswamy M, Waugh R, Hinderliter A, Sherwood A. Cerebrovascular risk factors, vascular disease, and neuropsychological outcomes in adults with major depression. Psychosom Med. 2007; 69 (6):578–586. doi:10.1097/PSY.0b013e31812f7b8e
33.
go back to reference Hofman A, Ott A, Breteler MM, et al. Atherosclerosis, apolipoprotein E, and the prevalence of dementia and Alzheimer’s disease in the Rotterdam Study. Lancet. 1997; 349: 151-154.CrossRefPubMed Hofman A, Ott A, Breteler MM, et al. Atherosclerosis, apolipoprotein E, and the prevalence of dementia and Alzheimer’s disease in the Rotterdam Study. Lancet. 1997; 349: 151-154.CrossRefPubMed
35.
37.
go back to reference * Unverzagt FW, McClure LA, Wadley VG, Jenny NS, Go RC, Cushman M, Kissela, BM, Kelley BJ, Kennedy R, Moy CS, Howard V, Howard G. Vascular risk factors and cognitive impairment in a stroke-free cohort. Neurol. 2011; 77:1729–1736 * Unverzagt FW, McClure LA, Wadley VG, Jenny NS, Go RC, Cushman M, Kissela, BM, Kelley BJ, Kennedy R, Moy CS, Howard V, Howard G. Vascular risk factors and cognitive impairment in a stroke-free cohort. Neurol. 2011; 77:1729–1736
40.
go back to reference Scuteri A, Coluccia R, Castello L, et al. Left ventricular mass increase is associated with cognitive decline and dementia in the elderly independently of blood pressure. Eur Heart J. 2009; 30: 1525-1529. doi:10.1093/eurheartj/ehp13.CrossRefPubMed Scuteri A, Coluccia R, Castello L, et al. Left ventricular mass increase is associated with cognitive decline and dementia in the elderly independently of blood pressure. Eur Heart J. 2009; 30: 1525-1529. doi:10.​1093/​eurheartj/​ehp13.CrossRefPubMed
42.
go back to reference Tanaka S, Tasuda T, Ishida T, et al. Increased serum cholesterol esterification rates predict coronary heart disease and sudden death in a general population. Arterioscler Thromb Vasc Biol. 2013; 33: 1098-1104.CrossRefPubMed Tanaka S, Tasuda T, Ishida T, et al. Increased serum cholesterol esterification rates predict coronary heart disease and sudden death in a general population. Arterioscler Thromb Vasc Biol. 2013; 33: 1098-1104.CrossRefPubMed
43.
go back to reference * Brady CB, Spiro III A, McGlinchey-Berroth R, Milberg W, Gaziano JM. Stroke risk predicts verbal fluency decline in healthy older men: Evidence from the normative aging study. J Gerontol: Psychol Sci. 2001;56B (6):340–346 * Brady CB, Spiro III A, McGlinchey-Berroth R, Milberg W, Gaziano JM. Stroke risk predicts verbal fluency decline in healthy older men: Evidence from the normative aging study. J Gerontol: Psychol Sci. 2001;56B (6):340–346
44.
go back to reference * Weiner MF, Hynan LS, Rossetti H, Warren MW, Cullum CM. The relationship of montreal cognitive assessment scores to Framingham coronary and stroke risk scores. Open J Psychiatry. 2011; 1:49–55 * Weiner MF, Hynan LS, Rossetti H, Warren MW, Cullum CM. The relationship of montreal cognitive assessment scores to Framingham coronary and stroke risk scores. Open J Psychiatry. 2011; 1:49–55
46.
go back to reference * Jak AJ, Urban S, McCauley A, Bangen KJ, Delano-Wood L, Corey-Bloom J, Bondi MW. Profile of hippocampal volumes and stroke risk varies by neuropsychological definition of mild cognitive impairment. J Int Neuropsychol Soc. 2009; 15 (6):890–897. doi:10.1017/S1355617709090638 * Jak AJ, Urban S, McCauley A, Bangen KJ, Delano-Wood L, Corey-Bloom J, Bondi MW. Profile of hippocampal volumes and stroke risk varies by neuropsychological definition of mild cognitive impairment. J Int Neuropsychol Soc. 2009; 15 (6):890–897. doi:10.1017/S1355617709090638
47.
go back to reference * Bangen KJ, Delano-Wood L, Wierenga CE, McCauley A, Jeste DV, Salmon DP, Bondi MW. Associations between stroke risk and cognition in normal aging and Alzheimer’s disease with and without depression. Int J Geriat Psychiatry. 2009; 25:175–182. doi:10.1002/gps.2317 * Bangen KJ, Delano-Wood L, Wierenga CE, McCauley A, Jeste DV, Salmon DP, Bondi MW. Associations between stroke risk and cognition in normal aging and Alzheimer’s disease with and without depression. Int J Geriat Psychiatry. 2009; 25:175–182. doi:10.1002/gps.2317
48.
go back to reference Lafosse JM, Reed BR, Mungas D, et al. Fluency and memory differences between ischemic vascular dementia and Alzheimer’s disease. Neuropsychology. 1997; 11: 514-522.CrossRefPubMed Lafosse JM, Reed BR, Mungas D, et al. Fluency and memory differences between ischemic vascular dementia and Alzheimer’s disease. Neuropsychology. 1997; 11: 514-522.CrossRefPubMed
49.
go back to reference Starkstein SE, Sabe L, Vazquez S, et al. Neuropsychological, psychiatric, and cerebral blood flow findings in vascular dementia and Alzheimer’s disease. Stroke. 1996; 27: 408-414.CrossRefPubMed Starkstein SE, Sabe L, Vazquez S, et al. Neuropsychological, psychiatric, and cerebral blood flow findings in vascular dementia and Alzheimer’s disease. Stroke. 1996; 27: 408-414.CrossRefPubMed
50.
go back to reference Wright RW, Brand RA, Dunn W, et al. How to write a systematic review. Clin Orthop Relat Res. 2007; 455: 23-29.CrossRefPubMed Wright RW, Brand RA, Dunn W, et al. How to write a systematic review. Clin Orthop Relat Res. 2007; 455: 23-29.CrossRefPubMed
52.
go back to reference Chinn S. A simple method for converting an odds ratio to effect size for use in meta-analysis. Stat Med. 2000; 19: 3127-3131.CrossRefPubMed Chinn S. A simple method for converting an odds ratio to effect size for use in meta-analysis. Stat Med. 2000; 19: 3127-3131.CrossRefPubMed
54.
go back to reference Rosenthal R. Meta-analytic procedures for social research. reth ed. Newbury Park: Sage; 1991.CrossRef Rosenthal R. Meta-analytic procedures for social research. reth ed. Newbury Park: Sage; 1991.CrossRef
55.
go back to reference Lipsey MW, Wilson DB. Practical meta-analysis. Thousand Oaks: Sage Publications; 2001. Lipsey MW, Wilson DB. Practical meta-analysis. Thousand Oaks: Sage Publications; 2001.
58.
go back to reference Schmidt FL, Oh IS, Hayes TL. Fixed- versus random-effects models in meta-analysis: model properties and an empirical comparison of differences in results. Br J Math Stat Psychol. 2009; 62(Pt 1): 97-128.CrossRefPubMed Schmidt FL, Oh IS, Hayes TL. Fixed- versus random-effects models in meta-analysis: model properties and an empirical comparison of differences in results. Br J Math Stat Psychol. 2009; 62(Pt 1): 97-128.CrossRefPubMed
59.
go back to reference Rocca WA, Petersen RC, Knopman DS, et al. Trends in the incidence and prevalence of Alzheimer’s disease, dementia, and cognitive impairment in the United States. Alzheimer’s Dementia. 2011; 7(1): 80-93.CrossRefPubMedCentralPubMed Rocca WA, Petersen RC, Knopman DS, et al. Trends in the incidence and prevalence of Alzheimer’s disease, dementia, and cognitive impairment in the United States. Alzheimer’s Dementia. 2011; 7(1): 80-93.CrossRefPubMedCentralPubMed
62.
go back to reference Woodruff BK, Graff-Radford NR, Ferman TJ, et al. Family history of dementia is a risk factor for Lewy body disease. Neurology. 2006; 66(12): 1949-1950.CrossRefPubMed Woodruff BK, Graff-Radford NR, Ferman TJ, et al. Family history of dementia is a risk factor for Lewy body disease. Neurology. 2006; 66(12): 1949-1950.CrossRefPubMed
63.
go back to reference Sparks DL, Kryscio RJ, Sabbagh MN, et al. Reduced risk of incident AD with elective statin use in a clinical trial cohort. Curr Alzheimer Res. 2008; 5: 416-421.CrossRefPubMed Sparks DL, Kryscio RJ, Sabbagh MN, et al. Reduced risk of incident AD with elective statin use in a clinical trial cohort. Curr Alzheimer Res. 2008; 5: 416-421.CrossRefPubMed
64.
go back to reference Gons RA, van Norden AG, de Laat KF, et al. Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter. Brain. 2011; 134(pt 7): 2216-2224. doi:10.1093/brain/awr145. Gons RA, van Norden AG, de Laat KF, et al. Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter. Brain. 2011; 134(pt 7): 2216-2224. doi:10.​1093/​brain/​awr145.
67.
go back to reference * Kaffashian S, Dugravot A, Brunner EJ, Sabia S, Ankri J, Kivimaki M, Singh-Manoux A. Midlife stroke risk and cognitive decline: a 10-year follow-up of the Whitehall II cohort. Alzheimer’s Dement. 2013; 9:572–579. doi:10.1016/j.jalz.2012.07.001 * Kaffashian S, Dugravot A, Brunner EJ, Sabia S, Ankri J, Kivimaki M, Singh-Manoux A. Midlife stroke risk and cognitive decline: a 10-year follow-up of the Whitehall II cohort. Alzheimer’s Dement. 2013; 9:572–579. doi:10.1016/j.jalz.2012.07.001
68.
go back to reference * Kaffashian S, Dugravot A, Elbaz A, et al. Predicting cognitive decline: a dementia risk score vs the Framingham vascular risk scores. Neurology. 2013; 80:1300–1306. doi:10.1212/WNL.0b013e31828ab370 * Kaffashian S, Dugravot A, Elbaz A, et al. Predicting cognitive decline: a dementia risk score vs the Framingham vascular risk scores. Neurology. 2013; 80:1300–1306. doi:10.1212/WNL.0b013e31828ab370
69.
go back to reference * Merrill DA, Siddarth P, Kepe V, Raja PV, Saito N, Ercoli LM, Miller KJ, Lavretsky H, Bookheimer SY, Barrio JR, Small GW. Vascular risk and FDDNP-PET influence cognitive performance. J Alzheimers Dis. 2013; 35 (1):147–157. doi:10.3233/JAD-121903 * Merrill DA, Siddarth P, Kepe V, Raja PV, Saito N, Ercoli LM, Miller KJ, Lavretsky H, Bookheimer SY, Barrio JR, Small GW. Vascular risk and FDDNP-PET influence cognitive performance. J Alzheimers Dis. 2013; 35 (1):147–157. doi:10.3233/JAD-121903
70.
go back to reference * Sheline YI, Barch DM, Garcia K, Gersing K, Pieper C, Welsh-Bohmer K, Steffens DC, Doraiswamy PM. Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biol Psychiatry. 2006; 60 (1):58–65 * Sheline YI, Barch DM, Garcia K, Gersing K, Pieper C, Welsh-Bohmer K, Steffens DC, Doraiswamy PM. Cognitive function in late life depression: relationships to depression severity, cerebrovascular risk factors and processing speed. Biol Psychiatry. 2006; 60 (1):58–65
71.
go back to reference * Smith PJ, Blumenthal JA, Babyak MA, Hinderliter A, Sherwood A. Association of vascular health and neurocognitive performance in overweight adults with high blood pressure. J Clin Exp Neuropsychol. 2011; 33 (5):559–566 * Smith PJ, Blumenthal JA, Babyak MA, Hinderliter A, Sherwood A. Association of vascular health and neurocognitive performance in overweight adults with high blood pressure. J Clin Exp Neuropsychol. 2011; 33 (5):559–566
Metadata
Title
Composite Cardiovascular Risk Scores and Neuropsychological Functioning: A Meta-Analytic Review
Authors
Jonathan DeRight, Ph.D.
Randall S. Jorgensen, Ph.D.
Misaell J. Cabral, B.S.
Publication date
01-06-2015
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 3/2015
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-014-9681-0

Other articles of this Issue 3/2015

Annals of Behavioral Medicine 3/2015 Go to the issue