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Hypertension, dyslipidemia, diabetes, smoking and obesity are considered to be the key cardiovascular risk factors (CVRFs) of cognitive impairment and decline.more and more evidence supports the association between middle-aged CVRFs and dementia risk, but little is known about whether CVRFs affects middle-aged cognition.therefore, Yaffe K et al. From the United States explored the association between CVRFs and cognitive decline in middle age.the results were published online in neurology.yimaitong is compiled and collated. Please do not reprint it without authorization.Introduction to the CARDIA study, a multicenter longitudinal study designed to assess the risk factors for coronary artery disease, included 5115 participants aged 18-30 years from 1985 to 1986. They were followed up for 25 years, and their blood pressure was measured at baseline, 2.5 years, 7 years, 10 years, 15 years, 20 years and 25 years (as a cumulative variable, the measured value multiplied by the number of years of follow-up visits).in order to assess the impact of CVRF exposure on cognitive changes during middle age, 2675 participants were included as the baseline of the study in the 25th year (2010-2011) and completed the cognitive test five years later.main findings: ➤ 5% of participants (n = 143) experienced accelerated cognitive decline within 5 years.➤ in the uncorrected model, the probability of accelerated cognitive decline within 5 years was associated with hypertension (7.5% vs 4.3%, or = 1.79, 95% CI 1.27-2.52), diabetes (10.3% vs 4.7%, or = 2.33, 95% CI 1.53-3.56) and smoking (7.7% vs 4.3%, or = 1.87, 95% CI 1.21-2.90) within 5 years.there was no significant effect on high cholesterol and obesity (high cholesterol: 6.9% vs 5.2%, or = 1.35, 95% CI 0.80-2.28; obesity: 6.1% vs 4.8%, or = 1.29, 95% CI 0.92-1.82).➤ Figure 1 shows the results of these associations (across the cohort and stratified by ethnicity) after multivariate adjustment for factors such as age, gender, race, education, depression, ApoE gene, and alcohol consumption.in the entire cohort, the association between hypertension (adjusted or, AOR = 1.87, 95% CI 1.26-2.75) and diabetes (AOR = 2.45, 95% CI 1.54-3.88) was still significant, and the association with smoking (AOR = 1.65, 95% CI 1.00-2.71) was also close to significant.when stratified by race, the association pattern between CVRF and accelerated decline in cognitive ability was similar.Figure 1 in 2675 cardia patients, the likelihood of accelerated decline in multivariate adjusted cognitive ability after 5 years of exposure to cardiovascular risk factors in middle age ➤ in the entire sample, 26.2% (n = 700) participants had 0 CVRF exposure, 25.9% (n = 692) had 1 CVRF exposure, 25.8% (n = 689) had 2 CVRF exposures, and 22.0% (n = 594) had 3 or more CVRF exposures.Table 1 shows the relationship between the cumulative number of CVRF exposures and the probability of accelerated decline.the probability of accelerated cognitive decline increased with the increase of the number of CVRF.Table 1 the possibility that the cumulative increase of cardiovascular disease risk factors accelerates the decline of cognitive ability in middle-aged people reveals that cardiovascular risk factors are more common in middle-aged people, especially hypertension, diabetes mellitus and smoking, and are related to the accelerated decline of cognitive ability in middle-aged people. these findings identify potential variables for preventing cognitive decline in middle age and emphasize the need for a life course approach to cognitive function and aging. yimaitong was compiled from: Yaffe K, et al. Cardiovascular risk factors and accelerated cognitive decline in midlife: the CARDIA study. Neurology. 2020 Jul 15; 10.1212/wnl.0000000000010078. Doi: 10.1212/wnl.0000000000 10078. Doi: 10.1212/wnl.0000000000 10078