Heart Risks in Midlife Tied to Greater Cognitive Decline in Women

January 25, 2022

Many middle-aged Americans have risk factors for heart disease, including diabetes and high blood pressure, and studies have shown that such risk factors are also tied to an increased risk of declines in memory and thinking skills. Now a new study suggests such risk factors may be especially risky for women. 

“Our results show that midlife cardiovascular conditions and risk factors were associated with midlife cognitive decline, but the association is stronger for women,” said study author Michelle M. Mielke, of the Mayo Clinic in Rochester, Minn. “We found that certain cardiovascular conditions, such as diabetes, heart disease and abnormally high levels of fats in the blood had stronger associations with cognitive decline in women compared to men.” 

The findings underscore the importance of regular monitoring and treatment for those with heart risks. Such treatment can not only help to prevent heart attacks and strokes; they may also help to curb declines in memory and thinking skills, and possibly help lower the risk of Alzheimer’s disease and other forms of dementia in old age.

In middle age, heart disease is more common in older men than women; after menopause, women eventually “catch up.” But monitoring and treatment, starting early, the findings suggest, may be especially important for women.   

The study, published in Neurology, looked at 1,857 men and women in their 50s and 60s. None had Alzheimer’s or other forms of dementia at the study’s start, though nearly 80 percent had at least one risk factor for heart disease. 

The researchers considered various conditions that can affect heart health, including heart disease, heart rhythm disorders like atrial fibrillation, heart failure, vascular disease and stroke. They also looked at risk factors like high blood pressure, diabetes, high cholesterol and other blood fats, smoking and obesity. 

Study participants got regular checkups and tests of memory and thinking skills over the next three years. The researchers found that heart risks were tied to declines in memory and thinking skills, especially for women. Women with heart disease, for instance, had a two-fold greater decline in cognitive tests compared to men with heart disease.  

In addition, heart disease, diabetes and high levels of cholesterol and fats in the blood were tied to language declines in women, whereas heart failure was linked to language declines in men. 

The study does not prove that women with heart risks will have cognitive decline, it only shows there is an association. The researchers speculate that higher overall stress levels in women compared to men, hormones and other factors may play a role in the disproportionate impact on women’s brain health, but say that more research is needed to better understand how sex differences impact heart and brain health. 

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University. 

Source: Nan Huo, MD, PhD; Prashanthi Vemuri, PhD; Jonathan Graff-Radford, MD;  et al: “Sex Differences in the Association Between Midlife Cardiovascular Conditions or Risk Factors With Midlife Cognitive Decline.” Neurology, January 5, 2022 


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