Summary: A twin study finds that better cardiovascular health is linked to stronger cognitive function.
Source: Emory Health Sciences
Emory University researchers report new evidence that maintaining good cardiovascular health supports brain health. A study published in the Journal of Alzheimer’s Disease shows that higher cardiovascular health scores are associated with better cognitive performance.
The American Heart Association (AHA) defines ideal cardiovascular health (CVH) using seven modifiable factors: blood glucose, total cholesterol, blood pressure, body mass index (BMI), physical activity, diet, and cigarette smoking. Higher CVH scores indicate healthier cardiovascular profiles and a lower risk of cardiovascular disease (CVD).
Previous studies have linked ideal CVH to improved cognitive aging and brain health, but questions remained about how much of that link is driven by genetics versus shared environmental or familial influences. To address this, researchers from Emory examined pairs of brothers from the Vietnam Era Twin (VET) Registry to disentangle genetic and shared environmental contributions to the CVH–cognition relationship.
Twin studies offer a powerful design to separate inherited factors from environmental influences. Monozygotic (identical) twins share nearly all of their genetic material, while dizygotic (fraternal) twins share about half on average. When a trait shows greater similarity among identical twins than fraternal twins, genetics are likely playing a strong role. If similarities are comparable between twin types, shared family environment and early-life exposures may be more important.
“Across the full sample, better cardiovascular health was associated with stronger cognitive performance in several domains,” says Viola Vaccarino, MD, PhD, Wilton Looney Professor of Cardiovascular Research at Emory’s Rollins School of Public Health and professor of cardiology at Emory University School of Medicine. “Our analyses suggest that much of this association can be explained by familial factors shared by twin brothers, indicating that early life circumstances may shape both heart and brain health.”
To determine whether shared familial factors were genetic or environmental, investigators performed within-pair analyses separately for monozygotic and dizygotic twins. If genetics were the dominant driver, associations between CVH and cognition would be stronger among identical twins. Instead, the within-pair associations were similar for identical and fraternal pairs, pointing to shared familial influences—such as early family environment, childhood socioeconomic conditions, education, and parenting—rather than inherited genes alone.
“Raising population-level cardiovascular health is an important public health goal,” says co-author Ambar Kulshreshtha, MD, PhD, assistant professor of family and preventive medicine at Emory University School of Medicine. “Because the seven CVH factors are modifiable, preventing cardiovascular risk factors and encouraging healthy lifestyles early in life could improve both heart and cognitive outcomes later on.”
Source:
Emory Health Sciences
Media contact:
Megan Jentz – Emory Health Sciences
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Image is in the public domain.
Original research: Open access. Article: “Association Between Cardiovascular Health and Cognitive Performance: A Twins Study” by Viola Vaccarino et al., Journal of Alzheimer’s Disease. DOI: 10.3233/JAD-190217.
Abstract summary
Background and objective: The American Heart Association’s 2020 Strategic Impact Goal aimed to improve cardiovascular health for all Americans by 20%. AHA’s CVH metric is based on seven modifiable risk factors. Prior work links ideal CVH with better cognitive aging, but familial factors could explain part of this relationship.
Methods: The study included 272 male twin pairs (544 individuals) from the Vietnam Era Twin Registry who were free of overt cardiovascular disease and dementia. Cognitive function was assessed with tests capturing memory, learning, and processing speed, including Trail Making tests and components of the Wechsler Memory Scale. Each CVH component—smoking status, BMI, physical activity, diet quality, total cholesterol, blood pressure, and blood glucose—was scored per established criteria.
Results: The average age of participants was 55 years; most were white and 61% were monozygotic. When analyzed as individuals, a one-unit increase in CVH score was associated with faster processing speed and improved immediate and delayed story recall. Specifically, higher CVH related to shorter completion times on Trail Making Test B and better scores on immediate and delayed recall measures.
Conclusions: Better cardiovascular health is linked with superior cognitive performance across several domains. Within-pair analyses suggest that shared familial influences—likely early-life environmental factors—account for a substantial portion of this association. These findings underscore the importance of early prevention and healthy lifestyle promotion to support both cardiovascular and cognitive health.