A recent study suggests that Black women suffering from heart health issues may be more prone to earlier cognitive decline compared to white women. The research was conducted over a 20-year period, with cognitive assessments completed regularly throughout an almost ten-year follow-up period. While processing speed declined in Black women during midlife, working memory did not decline in either group. The study, published in the Journal of the American Heart Association, focused on 765 women aged between 42 and 52 enrolled in the SWAN study in Chicago. The participants included both Black and white women who did not have cardiovascular disease.

The researchers measured cardiovascular health using the American Heart Association’s Life’s Essential 8 checklist, which includes factors such as blood pressure, body mass index, glucose, cholesterol, smoking, physical activity, diet, and sleep. Dr. José Morales, a vascular neurologist and neurointerventional surgeon, emphasized the importance of addressing these cardiovascular risk factors early in order to prevent cognitive decline. The study aimed to investigate whether better cardiovascular health was associated with less cognitive decline in both Black and white midlife women. The findings indicated that processing speed declined in Black women with lower cardiovascular health, while working memory did not decline in either Black or white women with lower heart health.

Imke Janssen, a professor at Rush University Medical Center and an author of the study, noted that within the Black subgroup, those with lower cardiovascular health declined faster than those with higher cardiovascular health. Factors such as blood pressure and smoking were identified as main contributors to this heterogeneity within the Black subgroup. Black Americans are more likely to be affected by hypertension at an earlier age and have lower hypertension control compared to white individuals. Moreover, Black individuals have higher exposure to nicotine, which has been linked to worse cognitive functioning, including processing speed.

Janssen emphasized the importance of optimizing cardiovascular health in midlife Black women to potentially slow cognitive aging, increase independence, and reduce racial inequality in dementia risk. She suggested that a clinical study is warranted to determine if improvements in cardiovascular health could positively impact cognitive health. Morales agrees that further research is needed to explore the differences in working memory between Black and white women. He suggested that future studies should be designed to measure differences in working memory without the confounding factor of practice effects, in order to validate the findings of the current study.

Overall, the study highlights the potential link between cardiovascular health and cognitive decline, particularly in Black women. By understanding and addressing cardiovascular risk factors early on, it may be possible to mitigate cognitive decline and reduce the risk of dementia. More research is needed to fully comprehend the mechanisms underlying these disparities and to determine the most effective strategies for promoting cognitive health in vulnerable populations.

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