Cardiovascular disease risk factor burden and cognition: Implications of ethnic diversity within the Hispanic Community Health Study/Study of Latinos

PLoS One. 2019 Apr 22;14(4):e0215378. doi: 10.1371/journal.pone.0215378. eCollection 2019.

Abstract

Objective: Hispanics/Latinos have some of the highest prevalence rates for cardiovascular disease risk factors, but stark differences exist by self-reported background. Cardiovascular disease risk factors negatively impact cognition in Hispanics/Latinos; less is known about these relationships by Hispanic/Latino backgrounds. We investigated cognitive associations with cardiovascular disease risk factor burden in a diverse cohort, the Hispanic Community Health Study/Study of Latinos.

Methods: Baseline data from this observational study of cardiovascular disease and its antecedents was collected from 2008-2011. We included 7,121 participants 45-74 years old from Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American backgrounds. Dichotomous indicators for hypertension, diabetes, hypercholesterolemia, obesity, and smoking were evaluated and totaled, with participants grouped by lowest (0-2), middle (3) or highest (4-5) burden. Cognitive testing included the Brief Spanish English Verbal Learning Test, letter fluency, and digit symbol substitution.

Results: In separate fully-adjusted linear regression models, lower fluency and digit symbol substitution performance were restricted to the highest compared to the lowest burden group; whereas the middle burden group displayed impaired memory performance compared to the lowest burden group (p-values≤0.05). Background interacted with burden for learning and memory performance. That is, the association of burden level (i.e., lowest, middle, or highest) with cognitive performance was modified by background (e.g., Mexicans vs Cuban).

Conclusions: Hispanics/Latinos with higher levels of cardiovascular disease risk factor burden displayed lower levels of cognitive performance, with learning and memory performance modified by background.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / physiopathology*
  • Cognition / physiology*
  • Cohort Studies
  • Cultural Diversity*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / ethnology
  • Female
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypercholesterolemia / ethnology
  • Hypertension / epidemiology
  • Hypertension / ethnology
  • Linear Models
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Obesity / ethnology
  • Prevalence
  • Public Health / statistics & numerical data*
  • Risk Factors
  • United States / epidemiology