Background: The purpose of this prospective cohort study was to examine whether the level of cognitive function at the baseline expressed as a cognitive function composite score and score of specific domains predict the risk of first cardiovascular disease (CVD) events in middle-aged and older populations.
Methods: Seven thousand eighty-seven participants, men and women aged 45-72 years, were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006-2008 in the city of Kaunas, Lithuania. During 10 years of follow-up, the risk of first non-fatal events of CVD and death from CVD (excluding those participants with a documented history of CVD and/or ischemic heart disease (IHD) diagnosed at the baseline survey) was evaluated. Cox proportional hazards regression models were applied to examine how cognitive function predicts the first events of CVD.
Results: During the follow-up, there were 156 deaths from CVD (49 women and 107 men) and 464 first non-fatal CVD events (195 women and 269 men) registered. The total number of first CVD events was 620 (11.5%). After adjustment for sociodemographic factors, biological and lifestyle risk factors and illnesses, a decrease per 1 standard deviation in different cognitive function scores significantly increased the risk of a first event of CVD (immediate verbal recall score - by 17% in men and 32% in women; delayed verbal recall score - by 17% in men and 24% in women; and a composite score of cognitive function - by 15% in men and 29% in women). Kaplan-Meier survival curves for the probability of a first cardiovascular event according to the categories of a composite score of cognitive function, revealed that a lowered cognitive function predicts a higher probability of the events compared to normal cognitive function (p < 0.05).
Conclusions: The findings of this follow-up study suggest that men and women with lower cognitive functions have an increased risk for a first event of CVD compared to participants with a higher level of cognitive functions.
Keywords: Cardiovascular mortality; Cognitive functions; Cohort study; Risk of first cardiovascular disease event.