Being heart smart could prevent cognitive decline in women
New research has revealed that cardiovascular risk factors, particularly high cholesterol, play a role in the development of cognitive decline, further highlighting the importance of kickstarting healthy heart habits earlier in life.
Professor Cassandra Szoeke, director of the Healthy Ageing Program at the University of Melbourne and lead researcher, said the results showed that strategies to target vascular damage are vital to prevent brain cell loss.
“Neurodegenerative brain disease works insidiously for decades before people are diagnosed with dementia – we need to stop it in its tracks, or ideally before it starts.”
“What you do now affects what you will be decades later.”
What did the study involve?
The Australian study, published in Brain Imaging and Behaviour, included 135 participants from the Women’s Healthy Ageing Project. These women had completed midlife cardiovascular risk measurement in 1992, followed by an MRI scan and cognitive assessment in 2012.
The researchers found that higher midlife Framingham Cardiovascular Risk Profile (FCRP) score was associated with greater White Matter Hyperintensity (WMH) volume two decades later, and was predominantly driven by the impact of HDL cholesterol level.
Structural equation modelling demonstrated that the relationship between midlife FCRP score and late-life executive function was mediated by WMH volume.
“We saw those with low brain volume lost even more volume over the next 10 years,” Professor Szoeke said.
The authors wrote that their results indicated that intervention strategies targeting major cardiovascular risk factors at midlife might be effective in reducing the development of WMH lesions and thus late-life cognitive decline.
Massive exercise changes aren’t needed – but being active every day is key
“We all know we should eat healthily and exercise, but we also know many people who start up a program are not participating 3 months later, and 12 months later even less are still participating,” Professor Szoeke said.
Going into the study, her research team had expected that women who did intense physical activity would have the best cognition down the track.
“We found it was those who did activity every day over the 20 years of follow-up. It could be walking the block or gardening or a mix of Saturday dancing, Sunday walking home, and Monday walking to work – but it is each and every day for 20 years.”
Professor Szoeke said the impact of the research should be a greater recognition that vascular risk is modifiable, If it’s left unchanged, this will lead to brain damage in the form of WMH, low brain volume and poor cognition.
She said modifying this risk doesn’t mean a huge lifestyle change. In fact, the benefit can be obtained from just being more active.
“Move often and eat healthily. Choose what works for you, change it as you need, and do it each and every day.”
Women are disproportionately affected by dementia
Women account for around two-thirds of all dementia cases. Understanding the reasons behind this is an issue close to Professor Szoeke’s heart.
She said while women generally live 3 to 4 years more than men, it is not just an effect of age. The fact that the symptoms, assessment, treatment, management and prevention of heart disease differs between men and women suggested that cardiovascular risk also plays a role.
“Last year, the Australian Hidden Hearts report was released, showing that women have more heart disease, heart failure and stroke than men,” Professor Szoeke said.
“The Health Minister Greg Hunt has announced an update of women’s health policy. There has been $18 million announced for research to fill these gaps in knowledge, particularly highlighting issues not often focused on in traditional women’s health.”
She said the strategic areas for the new update reflect key issues for women, including mental health, dementia, chronic disease and healthy ageing.
“I hope we can quickly see major improvements with investment in these areas.”