Cognitive function, vascular risk factors and education. A cross-sectional study based on a cohort of 70-year-old men

Objectives, A low level of education is associated with an increased risk of developing a dementia disorder, as well as with a higher risk of cardiovascular disease, The aim of this study was to investigate the association between education and cardiovascular risk factors, and to study the relation between these factors and cognitive function in elderly men. Design. Cross-sectional population-based study, Setting. Uppsala, Sweden. Subjects. 504 men aged 69-74 years, participants in a longitudinal health survey concerning cardiovascular risk factors, Main outcome measure, Cognitive function as measured by a composite score of 13 standard psychometric tests. Results. A low level of education was associated with poorer cognitive performance, as well as with obesity, smoking, diabetes, high concentrations of serum triglycerides and plasma fibrinogen. In the entire cohort, subjects with obesity, smoking, diabetes or hypertriglyceridaemia showed impaired cognitive test results, independent of socio-economic factors. When stroke cases were excluded, obesity and smoking were still related to impaired cognitive function. Conclusions. Smoking and obesity with associated metabolic disturbances are inversely related both to educational level and to cognitive function. Cognitive decline of vascular origin is potentially preventable by treatment of risk factors. The question of whether the increased vascular risk contributes to the higher prevalence of cognitive disorders in individuals with low socio-economic status, needs to be further evaluated in longitudinal population-based studies.