Association Between Cardiovascular Health and Cognitive Performance: A Twins Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

<div class="section"> <a class="named-anchor" id="S1">  </a> <h5 class="section-title" id="d1186348e181">Background/Objective:</h5> <p id="P1">The 2020 Strategic Impact Goal introduced by the American Heart Association (AHA) aims at improving cardiovascular health (CVH) of all Americans by 20%. AHA defined ideal CVH across seven established modifiable risk factors for cardiovascular diseases. Prior studies have indicated that ideal CVH also benefits brain health and cognitive aging, but it is possible that this association is explained by familial factors. </p> </div><div class="section"> <a class="named-anchor" id="S2">  </a> <h5 class="section-title" id="d1186348e186">Methods:</h5> <p id="P2">We examined 272 male monozygotic and dizygotic twin pairs (total 544 subjects) free of overt cardiovascular disease and dementia from the Vietnam Era Twin Registry. Memory and learning were measured by Trail Making tests and Wechsler Memory Scale (Immediate and Delayed Memory tests and Visual Reproductive Test). Each of the seven CVH components (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was scored per established criterion. </p> </div><div class="section"> <a class="named-anchor" id="S3">  </a> <h5 class="section-title" id="d1186348e191">Results:</h5> <p id="P3">The mean age of the twins was 55 years, 96% were whites, and 61% monozygotic. When considering twins as individuals, for every unit increase in CVH score (indicating better cardiovascular health), twins demonstrated faster cognitive processing speed (Trail B: –5.6 s, 95%CI –10.3, –0.9; <i>p</i> = 0.03) and better story recall, both immediate (0.35, 95%CI 0.06, 0.62; <i>p</i> = 0.02) and delayed (0.39, 95%CI 0.08, 0.70; <i>p</i> = 0.01). </p> </div><div class="section"> <a class="named-anchor" id="S4">  </a> <h5 class="section-title" id="d1186348e205">Conclusions:</h5> <p id="P4">Better CVH is associated with better cognitive health in several domains. As suggested by within-pair analysis, this association is largely explained by familial factors, implying that early life exposures are shared determinants of both brain health and cardiovascular health. </p> </div>

Related collections

Most cited references 44

Record: found
Abstract: found
Article: not found

Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure.

Yuji Okura, Lynn H. Urban, Douglas Mahoney … (2004)

Questionnaires are used to estimate disease burden. Agreement between questionnaire responses and a criterion standard is important for optimal disease prevalence estimates. We measured the agreement between self-reported disease and medical record diagnosis of disease. A total of 2,037 Olmsted County, Minnesota residents > or =45 years of age were randomly selected. Questionnaires asked if subjects had ever had heart failure, diabetes, hypertension, myocardial infarction (MI), or stroke. Medical records were abstracted. Self-report of disease showed >90% specificity for all these diseases, but sensitivity was low for heart failure (69%) and diabetes (66%). Agreement between self-report and medical record was substantial (kappa 0.71-0.80) for diabetes, hypertension, MI, and stroke but not for heart failure (kappa 0.46). Factors associated with high total agreement by multivariate analysis were age 12 years, and zero Charlson Index score (P < .05). Questionnaire data are of greatest value in life-threatening, acute-onset diseases (e.g., MI and stroke) and chronic disorders requiring ongoing management (e.g.,diabetes and hypertension). They are more accurate in young women and better-educated subjects.

0 comments Cited 409 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Causal Inference and Observational Research: The Utility of Twins.

Matt McGue, Merete Osler, Kaare Christensen (2010)

Valid causal inference is central to progress in theoretical and applied psychology. Although the randomized experiment is widely considered the gold standard for determining whether a given exposure increases the likelihood of some specified outcome, experiments are not always feasible and in some cases can result in biased estimates of causal effects. Alternatively, standard observational approaches are limited by the possibility of confounding, reverse causation, and the nonrandom distribution of exposure (i.e., selection). We describe the counterfactual model of causation and apply it to the challenges of causal inference in observational research, with a particular focus on aging. We argue that the study of twin pairs discordant on exposure, and in particular discordant monozygotic twins, provides a useful analog to the idealized counterfactual design. A review of discordant-twin studies in aging reveals that they are consistent with, but do not unambiguously establish, a causal effect of lifestyle factors on important late-life outcomes. Nonetheless, the existing studies are few in number and have clear limitations that have not always been considered in interpreting their results. It is concluded that twin researchers could make greater use of the discordant-twin design as one approach to strengthen causal inferences in observational research.

0 comments Cited 159 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Regression models for twin studies: a critical review.

Terry Dwyer, B Carlin, Ruth Morley … (2005)

Twin studies have long been recognized for their value in learning about the aetiology of disease and specifically for their potential for separating genetic effects from environmental effects. The recent upsurge of interest in life-course epidemiology and the study of developmental influences on later health has provided a new impetus to study twins as a source of unique insights. Twins are of special interest because they provide naturally matched pairs where the confounding effects of a large number of potentially causal factors (such as maternal nutrition or gestation length) may be removed by comparisons between twins who share them. The traditional tool of epidemiological 'risk factor analysis' is the regression model, but it is not straightforward to transfer standard regression methods to twin data, because the analysis needs to reflect the paired structure of the data, which induces correlation between twins. This paper reviews the use of more specialized regression methods for twin data, based on generalized least squares or linear mixed models, and explains the relationship between these methods and the commonly used approach of analysing within-twin-pair difference values. Methods and issues of interpretation are illustrated using an example from a recent study of the association between birth weight and cord blood erythropoietin. We focus on the analysis of continuous outcome measures but review additional complexities that arise with binary outcomes. We recommend the use of a general model that includes separate regression coefficients for within-twin-pair and between-pair effects, and provide guidelines for the interpretation of estimates obtained under this model.

0 comments Cited 149 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Title: Journal of Alzheimer's Disease

Abbreviated Title: JAD

Publisher: IOS Press

ISSN (Print): 13872877

ISSN (Electronic): 18758908

Publication date Created: October 01 2019

Publication date (Print): October 01 2019

Volume: 71

Issue: 3

Pages: 957-968

Affiliations

[1 ]Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA

[2 ]Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA

[3 ]Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

[4 ]Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA

[5 ]Department of Psychiatry and Behavioral Sciences and the Department of Radiology, Emory University School of Medicine, and the Atlanta VA Medical Center, Decatur, GA, USA

[6 ]Vietnam Era Twin Registry, Seattle, WA, USA

[7 ]University of Washington School of Public Health, Seattle, WA, USA

Article

DOI: 10.3233/JAD-190217

PMC ID: 6918828

PubMed ID: 31476151

SO-VID: 5d966607-26e2-4ec1-b17c-74317011ef24

History

Data availability:

Comments

Comment on this article

scite_

Cited by 10

See all cited by

Most referenced authors 992

See all reference authors

- Version 1

Association Between Cardiovascular Health and Cognitive Performance: A Twins Study

Read this article at

Abstract

Related collections

NTT Journal for Theology and the Study of Religion

Most cited references 44

Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure.

Causal Inference and Observational Research: The Utility of Twins.

Regression models for twin studies: a critical review.

Author and article information

Journal

Affiliations

Article

History

Comments

Comment on this article

Similar content 3,263

Cited by 10

Most referenced authors 992