Women with certain cardiovascular conditions in midlife may be more at risk of cognitive decline than their male peers, a recent study finds.
Brain health is intricately bound to the health of our heart. In fact, more and more research is showing that cardiovascular conditions, such as stroke and heart disease, are closely linked with increased odds of developing dementia. But for middle-aged women, new research suggests that several cardiovascular conditions could have more pernicious effects on brain function than is the case for men.
In the study, published in Neurology, researchers found that women with certain cardiovascular diseases including coronary heart disease, the most common type of heart disease, and risk factors of these diseases like diabetes, tended to experience greater cognitive decline compared to their male counterparts.
“It is striking that although men have a higher prevalence of cardiovascular risk factors and conditions in midlife, the impact of most of these conditions on cognition is stronger for women,” the study’s authors wrote.
The study is part of a broader scientific effort to identify sex-specific variables that heightens people’s risk of cognitive impairment. Across the globe, dementia disproportionately impacts females, and research shows that women living with dementia outnumbered men by 100 to 69 in 2019. As this trend is projected to continue through 2050, scientists emphasize the importance of studying dementia risk factors across women’s lifespan — and strategies to prevent or delay cognitive impairment.
When it comes to heart health, middle-aged men are actually at greater risk of developing coronary heart disease; they also tend to have cardiovascular risk factors like diabetes at a younger age than women, according to the recent study’s researchers. But there appear to be sex differences in how various cardiovascular conditions affect brain health, the team said.
“While all men and women should be treated for cardiovascular conditions and risk factors in midlife, additional monitoring of women may be needed as a potential means of preventing cognitive decline,” Mayo Clinic epidemiologist and neuroscientist Michelle Mielke, the study’s senior author, said in a news release.
For the study, Mielke and colleagues analyzed data of men and women, who did not have dementia, between the ages of 50 and 69 at baseline. The participants underwent medical evaluations every 15 months over an average of three years.
Nearly 1,500 participants, or about 79 percent of the sample, had at least one cardiovascular disease or risk factor, and a larger proportion of men had these conditions than women.
But certain cardiovascular conditions were more strongly associated with women’s cognition than men, the team observed. In particular, the rate of decline in overall cognitive functioning was twice as fast for females with coronary heart disease, compared to their male counterparts.
Congestive heart failure was significantly correlated with a decline in men’s language skills. But diabetes, high cholesterol and coronary heart disease were all significantly associated with a decline in women’s language skills, and not in men.
Mielke cautioned against overinterpreting the sex differences in the link between language abilities and cardiovascular conditions; follow-up research is needed to validate the findings.
Future studies should also examine biological mechanisms behind the sex differences in the link between cardiovascular conditions and cognition, the team said. The researchers posited that a host of factors, including genetics, lifestyle, brain development and hormones, could all play a role. For instance, changes in women’s estrogen level during menopause may be one contributor, Mielke suggested; but the stresses of juggling between a career and caregiving responsibilities for middle-aged women could be another variable.
Meanwhile, experts have underscored that there are strategies for both men and women to preserve or improve their heart and brain health. Maintaining a healthy diet, staying physically and socially active, avoiding smoking, and managing stress are all lifestyle choices that can protect our heart and brain.