To determine if higher scores on the American Heart Association (AHA) Life’s Simple 7 in midlife are associated with a decreased risk of dementia among women.

A growing body of research underscores the need to examine midlife risk factors for dementia, as dementia pathology often begins decades before diagnosis.

The study population included women enrolled in the Women’s Health Study who had available risk factor information needed to calculate the AHA Life’s Simple 7 at baseline (1992-1994) and approximately ten years later (2004) and were fully covered by fee-for-service Medicare for all eligible person-months.  Women received one point for each component of the AHA Life’s Simple 7 (smoking status, diet, physical activity, body mass index, diabetes, blood cholesterol, and blood pressure) for which they had ideal cardiovascular health. We used fee-for-service Medicare data (available from 2011 through 2018) and validated lists of ICD-9 and ICD-10 codes to identify dementia diagnoses.  We used logistic regression to examine the association between the score, modeled as a continuous variable, and dementia diagnosis adjusted for age and socioeconomic status at baseline.

13,720 women were eligible for these analyses and 1771 (12.9%) dementia cases were observed. The mean age (standard deviation (SD)) was 54.2 (6.6) years at baseline. The average AHA Life’s Simple 7 score at baseline was 4.3 (SD=1.3) and after ten years of follow-up was 4.2 (SD=1.3).  Higher AHA Life’s Simple 7 score as measured at baseline (odds ratio per one unit change in score=0.94, 95% CI: 0.90-0.98) was associated with a decreased risk of dementia.  This effect was similar for the AHA Life’s Simple 7 score as measured after ten years of follow-up (OR=0.95, 95% CI: 0.91-1.00).

Better cardiovascular health in midlife was associated with a decreased risk of dementia in late life among women.