Does a woman’s heart health affect cognition in midlife?

A new study has found that Black women with poor cardiovascular health may face an elevated risk of early signs of cognitive decline in midlife.

The study, which is published in the Journal of the American Heart Association, included 363 Black and 402 white women who enrolled in the Chicago site of the Study of Women’s Health Across the Nation when they were 42–52 years old. Cognition (measured as processing speed and working memory) was assessed annually or biennially over a maximum of 20 years, with an average follow-up of 9.8 years. A composite index of cardiovascular health (Life’s Essential 8) was calculated based on blood pressure, body mass index, glucose, cholesterol, smoking, physical activity, diet, and sleep.

The question of interest was to determine whether better cardiovascular health was related to less cognitive decline equally for both Black and white midlife women.

Processing speed, a leading indicator of early cognitive decline, appeared to decline in Black women with poorer cardiovascular health starting in midlife but not in white women. Working memory did not decline in the total study group, or in groups based on race or cardiovascular health.

“The results suggest that promotion of cardiovascular health, particularly management of blood pressure and smoking cessation, in midlife Black women may be important for the early prevention of cognitive decline and maintenance of independence through aging,” said corresponding author Imke Janssen, Ph.D., of Rush University Medical Center. “A clinical trial should determine whether optimizing heart health in midlife slows cognitive decline.”