Women’s cognition in midlife may be linked to cardiovascular factors

middle aged female fastening her cycling helmet.
New research finds that neurological health is connected to heart health. Tara Moore/Getty Images
  • Heart health is vitally important for everyone, regardless of sex.
  • While more men have cardiovascular issues in midlife, women with these issues appear to experience a higher level of cognitive decline in midlife.
  • Women are encouraged to incorporate lifestyle changes to mitigate this association.

Cardiovascular issues are the leading cause of death worldwide. These serious conditions are often linked to other health issues.

A recent study, which appears in the medical journal Neurology, suggests that women with cardiovascular conditions in midlife may be at a higher risk for cognitive decline than men of the same age.

Health differences between sexes

Men and women appear particularly prone to specific conditions at various stages of life. For example, men generally develop risk factors such as hypertension, diabetes, and high cholesterol at a younger age than women.

Men also are at a higher risk of developing coronary heart disease. On the other hand, older women have a higher risk of stroke than men of the same age.

Numerous studies report associations between mid- or late-life cardiovascular issues and the risk of late-life dementia. Some studies also point to a link between midlife cardiovascular conditions and midlife cognitive decline.

However, there has been very little research on whether the link between heart health and cognitive health differs between the sexes.

Researchers investigate links

Researchers from the Mayo Clinic in Rochester, MN, investigated specifically the association between midlife cardiovascular conditions and mid-life cognition and whether this association was different between men and women.

According to study author Michelle M. Meilke, Ph.D., professor of Epidemiology and Neurology at the Mayo Clinic and a member of the American Academy of Neurology, the study’s results show that midlife cardiovascular conditions and risk factors are associated with midlife cognitive decline in both men and women. However, the degree of association differed between the sexes.

“We actually thought we would see more of an association among the men, but we ended up finding that although a greater percentage of men had cardiovascular factors in midlife, there seemed to be more of an effect on the cognition of the women with those factors,” said Prof. Meilke in an interview with MBL.

The study was funded by the National Institutes of Health (NIH) and the GHR Foundation. Participants included 1,857 people between 50–69 years who were enrolled in the Mayo Clinic Study of Aging and did not have dementia at the start of the study.

The participants were clinically evaluated every 15 months for 3 years. This included several tests to assess memory, language, executive function, and visuospatial skills.

Study results

The researchers found that while more men than women had at least one cardiovascular risk factor, the women who did have risk factors were more likely to experience a decline in cognition.

For example, those women with heart disease were more than twice as likely as the men to decline in composite cognitive test scores over the study period.

The results also indicated that different cardiovascular risk factors affected specific cognitive areas differently among the sexes. Diabetes, heart disease, and abnormally high levels of blood cholesterol were associated with a decline in language scores only in women. Congestive heart failure was associated with a decline in language scores only in men.

Dr. Randolph P. Martin, emeritus professor of Cardiology at Emory University Healthcare, and Chief Medical Officer, Caption Health, was asked by MBL to comment on the study.

“What’s really important about this study is that it showed unequivocally that women in midlife who have risk factors of high blood pressure, abnormalities of LDL cholesterol, diabetes, smoking, or obesity can also develop a cognitive decline in midlife and at a greater incidence than men.”

– Dr. Martin

Dr. Martin stressed the importance of lifestyle changes for women in their 40s and 50s who have any of these cardiovascular risk factors.

Prof. Mielke added that oftentimes there is a reduced level of urgency among healthcare providers in treating women with heart health-related issues.

“It’s really important for women to be treated more aggressively if they have any of these cardiovascular risk factors,” said Prof. Mielke.

The researchers note that more research is needed across a broader population since all participants were from a single county in Minnesota. They also stress that future research should focus on what other factors may contribute to the difference in midlife cognitive decline between the sexes.

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