Abstract 20831: Cognitive Ability, Lifestyle Risk Factors, and Two-Year Mortality in First Myocardial Infarction Men: A Swedish National Registry Study
Introduction: General cognitive ability (CA) estimated early in life is positively associated with later physical and mental health, health literacy, and longevity.
Methods: We investigated young adulthood CA as a long-term risk indicator for the lifestyle factors smoking, diabetes, hypertension, obesity, and two-year mortality in the largest sample to date of 60 years or younger Swedish first MI males. CA was estimated from mandatory conscript register data (INSARK) gathered when patients were 18-20 years old. The national quality register SWEDEHEART/RIKS-HIA provided data on cardiac functioning and lifestyle risk factors ~ 30 years later at first MI hospital admission. An additional two years later, the Cause of Death Register provided death dates for those deceased. The 5,680 complete cases including deceased (n = 110) and still alive (n = 5,570) were descriptively compared on CA, lifestyle risk factors and mortality. Logistic regression was used to model crude and adjusted associations.
Results: Early first MI non-survivors had 0.28 SD lower young adulthood CA (M = 4.38, SD = 1.49) compared to survivors (M = 4.81, SD = 1.51). The whole first MI group CA was also 0.13 SD lower (M = 4.80, SD = 1.51) than the expected population norm (M = 5.00, SD = 1.56). Adjusting for covariates, one SD increase in CA was associated with decreased probability of being a current smoking (OR = 0.62 [0.59, 0.67], P < 0.001), previous smoker (0.79 [0.73, 0.84], P < 0.001), having diabetes (0.81 [0.74, 0.89], P < 0.001), obesity (0.89 [0.84, 0.95], P < 0.001) at hospital admission, and increased odds of being alive two years thereafter (1.27 [1.04, 1.53], P < 0.001). CA was not associated with hypertension at hospital admission (1.04 [0.97, 1.11], P = 0.228).
Conclusion: This study confirms substantial inverse associations between CA, and lifestyle related cardiovascular risk factors, and mortality in the earliest first MI male patients. Our findings also expand the CA - morbidity association to comorbid diabetes and obesity. Since CA is highly stable from 18-65 years, can be cost-effectively estimated, and is presently not evaluated in clinical care, CA assessment might provide a better risk stratification and possibly aid further tailoring of secondary prevention.
Author Disclosures: J. Wallert: None. G. Madison: None. C. Held: None. E. Olsson: None.
- © 2016 by American Heart Association, Inc.