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59/100

✓ Peer-reviewed alzhub usefulness score 59 out of 100. Disparities

Topic: Risk, prevention and care in population studies

Objective Increasing evidence supports an association between midlife cardiovascular risk factors (CVRFs) and risk of dementia, but less is known about whether CVRFs influence cognition in midlife. We examined the relationship between CVRFs and midlife cognitive decline. Methods In 2,675 black and white middle-aged adults (mean age 50.2 ± 3.6 years, 57% female, 45% black), we measured CVRFs at baseline: hypertension (31%), diabetes mellitus (11%), obesity (43%), high cholesterol (9%), and current cigarette smoking (15%). We administered cognitive tests of memory, executive function, and processing speed at baseline and 5 years later. Using logistic regression, we estimated the association of CVRFs with accelerated cognitive decline (race-specific decline ≥1.5 SD from the mean change) on a composite cognitive score. Results Five percent (n = 143) of participants had accelerated cognitive decline over 5 years. Smoking, hypertension, and diabetes mellitus were associated with an increased likelihood of accelerated decline after multivariable adjustment (adjusted odds ratio [AOR] 1.65, 95% confidence interval [CI] 1.00-2.71; AOR 1.87, 95% CI 1.26-2.75; AOR 2.45, 95% CI 1.54-3.88, respectively), while obesity and high cholesterol were not associated with risk of decline. These results were similar when stratified by race. The likelihood of accelerated decline also increased with greater number of CVRFs (1-2 CVRFs: AOR 1.77, 95% CI 1.02-3.05; ≥3 CVRFs: AOR 2.94, 95% CI 1.64-5.28) and with Framingham Coronary Heart Disease Risk Score ≥10 (AOR 2.29, 95% CI 1.21-4.34). Conclusions Midlife CVRFs, especially hypertension, diabetes mellitus, and smoking, are common and associated with accelerated cognitive decline at midlife. These results identify potential modifiable targets to prevent midlife cognitive decline and highlight the need for a life course approach to cognitive function and aging.

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APA 7th

Yaffe, K., Bahorik, A. L., Hoang, T. D., Forrester, S., Jacobs, D. R., Lewis, C. E., et al. (2020). Cardiovascular risk factors and accelerated cognitive decline in midlife: The CARDIA Study. Neurology. https://doi.org/10.1212/wnl.0000000000010078

Vancouver

Yaffe K, Bahorik AL, Hoang TD, Forrester S, Jacobs DR, Lewis CE, et al. Cardiovascular risk factors and accelerated cognitive decline in midlife: The CARDIA Study. Neurology. 2020. doi:10.1212/wnl.0000000000010078. PMID: 32669394.

BibTeX

@article{yaffe2020-32669394,
  author  = {Yaffe, K. and Bahorik, A. L. and Hoang, T. D. and Forrester, S. and Jacobs, D. R. and Lewis, C. E. and Lloyd-Jones, D. M. and Sidney, S. and others},
  title   = {{Cardiovascular risk factors and accelerated cognitive decline in midlife: The CARDIA Study}},
  journal = {Neurology},
  year    = {2020},
  doi     = {10.1212/wnl.0000000000010078},
  pmid    = {32669394},
  url     = {https://doi.org/10.1212/wnl.0000000000010078}
}

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Key findings

Results Five percent (n = 143) of participants had accelerated cognitive decline over 5 years.
Smoking, hypertension, and diabetes mellitus were associated with an increased likelihood of accelerated decline after multivariable adjustment (adjusted odds ratio [AOR] 1.65, 95% confidence interval [CI] 1.00-2.71; AOR 1.87, 95% CI 1.26-2.75; AOR 2.45, 95% CI 1.54-3.88, respectively), while obesity and high cholesterol were not associated with risk of decline.
These results were similar when stratified by race.
Conclusions Midlife CVRFs, especially hypertension, diabetes mellitus, and smoking, are common and associated with accelerated cognitive decline at midlife.
These results identify potential modifiable targets to prevent midlife cognitive decline and highlight the need for a life course approach to cognitive function and aging.

Why it matters

In middle-aged adults, smoking, hypertension, and diabetes were linked to a higher likelihood of accelerated cognitive decline over 5 years, while obesity and high cholesterol were not. This suggests these cardiovascular risk factors may matter for midlife cognition, but the study did not test whether treating them prevents dementia.

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Study details

Participants143
Effect sizeAOR 1.87; AOR 2.45; AOR 1.77
Evidence strengthLow

How this study scored 59/100

Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (Neurology)
Journal's citation record	4 / 4	Neurology: journal h-index 525 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2020 — within 10 year(s) of the newest study here
Sample size	2 / 4	143 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 109 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	13.6 citations a year over 8 year(s) since 2020
Impact for its field and year	4 / 6	Cited 9.0× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	1 / 6	Cited by 2 other studies in this library
Still being cited	3 / 4	Cited 53 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Jared P. Reis: h-index 66 (OpenAlex, whole career)
Institution's track record	2 / 3	University of California, San Francisco: institution h-index 1,915 (OpenAlex)
Multi-centre collaboration	3 / 3	OpenAlex lists 10 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 32669394)
Free to read	0 / 2	Behind a paywall — scores zero
Total	59 / 100	—

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