Longitudinal association between midlife cardiovascular health and cognitive change in a bi-ethnic cohort

Authors

• Janette Vazquez, University of Texas Health Science Center at San Antonio
• Rebecca Bernal, University of Texas Health Science Center at San Antonio
• Luis Aguirre, University of Texas Health Science Center at San Antonio
• Jesus D. Melgarejo, The University of Texas Rio Grande Valley School of MedicineFollow
• Gladys Maestre, The University of Texas Rio Grande Valley School of MedicineFollow
• Sudha Seshadri, University of Texas Health Science Center at San Antonio
• Helen P. Hazuda, University of Texas Health Science Center at San Antonio
• Chen-Pin Wang, University of Texas Health Science Center at San Antonio
• Claudia Satizabal, University of Texas Health Science Center at San Antonio

Document Type

Article

Publication Date

9-2026

Abstract

Introduction: Midlife cardiovascular burden contributes to cognitive decline and dementia. However, research in diverse populations remains scarce.

Methods: We included 402 San Antonio Heart Study participants (1979–1988; midlife mean age 57.9 ± 3.8, 58.5% women, 52% Mexican American) later enrolled in the San Antonio Longitudinal Study of Aging (1992–2004). Midlife cardiovascular health was assessed using Life's Simple 7. Cognition was measured up to four times with the Mini-Mental State Examination. Generalized estimating equation models adjusted for age, sex, income, and education were used to relate cardiovascular factors to cognitive change. Sensitivity analyses evaluated attrition bias.

Results: Physical activity was associated with slower cognitive decline, particularly among Mexican Americans. Body mass index < 30 kg/m2 related to faster cognitive decline among Mexican Americans, but this was attenuated after attrition weighting. Fasting glucose < 126 mg/dL was associated with slower cognitive decline among non-Hispanic Whites in attrition-weighted models.

Discussion: Physical activity and glycemic status were differentially associated with cognitive change across ethnicities.

Comments

© 2026 The Author(s). Alzheimer's & Dementia: Behavior & Socioeconomics of Aging published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

Recommended Citation

Vazquez, Janette, Rebecca Bernal, Luis A. Aguirre, Jesus D. Melgarejo, Gladys Maestre, Sudha Seshadri, Helen P. Hazuda, Chen‐Pin Wang, and Claudia L. Satizabal. "Longitudinal association between midlife cardiovascular health and cognitive change in a bi‐ethnic cohort." Alzheimer's & Dementia: Behavior & Socioeconomics of Aging2, no. 3 (2026): e70096. https://doi.org/10.1002/bsa3.70096

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Publication Title

Alzheimer's & Dementia

DOI

10.1002/bsa3.70096

Academic Level

faculty

Mentor/PI Department

Neuroscience