Supplementary Material for: Association of Cardiovascular Health with Cognitive Function in U.S. Older Adults: a population-based cross-sectional study

Background: Promoting cardiovascular health (CVH) by Life’s Simple 7 is associated with better cognitive function. In 2022, the American Heart Association (AHA) prompted Life’s Essential 8 (LE8) to strengthen CVH assessment. This study investigated the association between the new CVH metrics assessed by LE8 and cognitive function, thus providing evidence for implementing LE8 in the primordial prevention of cognitive impairment.
Method: 2050 participants aged 60 and older from National Health and Nutrition Examination Survey 2011-2014 were included. Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). The overall and domain-specific cognitive function z-score was created. CVH score was calculated following AHA’s advisory. The multivariable linear regression model estimated the associations.
Results: The CVH score assessed by LE8 was independently, positively, and linearly associated with the overall cognitive function. A per-10 points increase in CVH was associated with higher overall cognitive z-scores (β, 0.06; 95% CI, 0.03, 0.09), and participants with moderate (β, -0.14; 95% CI, -0.22, -0.05) and low CVH (β, -0.27; 95% CI, -0.37, -0.16) had lower overall cognitive z-scores compared to participants with high CVH. Similar patterns of associations were observed between CVH of AFT and DSST. Components of CVH were further associated with different domain-specific cognitive functions.
Conclusion: Maintaining an ideal CVH improves cognitive function in older adults. Ideal adherence to individual components of LE8 were associated with improved overall and domain-specific cognitive functions. Therefore, promoting CVH according to LE8 might benefit cognitive function in the elderly.

背景：根据‘生活简单7’促进心血管健康（CVH）与改善的认知功能相关联。2022年，美国心脏协会（AHA）推动实施‘生命要素8’（LE8），以加强CVH的评估。本研究旨在探讨LE8评估的新CVH指标与认知功能之间的关联，从而为在认知障碍的原发性预防中实施LE8提供证据。
方法：纳入了2011-2014年全国健康与营养调查的2050名60岁及以上参与者。认知功能通过阿尔茨海默病注册研究联盟（CERAD）、动物流畅性测试（AFT）和数字符号替换测试（DSST）进行测量。创建了整体及特定领域的认知功能Z得分。CVH得分按照AHA的指导方针计算。多变量线性回归模型估计了这些关联。
结果：LE8评估的CVH得分与整体认知功能独立、正向且线性相关。CVH每增加10分，整体认知Z得分相应提高（β，0.06；95% CI，0.03，0.09），与高CVH的参与者相比，具有中等（β，-0.14；95% CI，-0.22，-0.05）和低CVH（β，-0.27；95% CI，-0.37，-0.16）的参与者整体认知Z得分较低。在AFT和DSST的CVH中观察到了相似的关联模式。CVH的各个组成部分与不同的特定领域认知功能进一步相关。
结论：维持理想的心血管健康状态可提升老年人群的认知功能。对LE8各组成部分的理想遵守与整体及特定领域的认知功能改善相关。因此，根据LE8促进心血管健康可能有益于老年人的认知功能。