Road to Healthy Middle-Aged Brain May Begin in Childhood
Could having heart disease risk factors in childhood sow the seeds of thinking declines in middle-age?
It looks like it might, new research claims.
"I think it was not so big of a surprise for us, but maybe for the scientific community who have been focusing mainly on the midlife risk factors and old-age cognition," said study co-author Suvi Rovio. She is senior researcher of cardiovascular medicine and adjunct professor in the department of clinical medicine at the University of Turku, in Finland.
"It is something really novel to put it down to the childhood, and show the same associations beginning from childhood," Rovio said.
For their research, her team used data from the Cardiovascular Risk in Young Finns Study, a national, longitudinal study. The researchers were able to follow participants for 31 years, starting in childhood.
The study included baseline clinical exams of nearly 3,600 girls and boys aged 3 to 18 in 1980. In 2011, more than 2,000 of the participants, then aged 34 to 49, took a computerized cognitive function ("thinking skills") test.
The investigators found that total cholesterol, as well as systolic blood pressure and body mass index, from childhood to midlife were associated with brain function.
Specifically, a high systolic blood pressure (the top number in a blood pressure reading) and high total and LDL ("bad") cholesterol were associated with worse memory and learning in midlife. Obesity from childhood to adulthood was linked to lower visual information processing speed and to maintaining attention.
All three were linked to poorer memory and associative learning, worse visual processing, decreased attention span, slower reaction time and slower movement.
Study first author Dr. Juuso Hakala said, "Our results indicate that monitoring and prevention of the cardiovascular risk factors beginning from childhood may turn into better brain health in midlife." Hakala is a PhD student at the Research Centre of Applied and Prevention Cardiovascular Medicine at the University of Turku.
"Risk factor reduction can be reached by healthy lifestyle choices, such as dietary habits, for example avoiding unhealthy food items," Hakala said. "But also promoting physical activity for children is one way to a healthy lifestyle, which children can carry on to adulthood and later in life as well."
If the participants had all three cardiovascular risk factors, they were almost seven years older in their memory and learning level as those with no risk factors, Hakala said. For visual processing and sustained attention, they were about 20 years older.
The study authors noted that past research has found that about 20% of people over 60 have mild loss of brain function. Many diseases that cause neurological deficits, such as Alzheimer's, are present long before noticeable symptoms begin.
"I think it's extremely important to note that it's never too late to make healthy lifestyle choices," Hakala said. "Lifestyle choices are the most effective ways to influence these risk factors. If our results are causally linked to cognitive functions, which I think they are, moving to a much better cardiovascular risk factor profile would thereby reduce the risk for poor cognitive function in later life as well."
The researchers are now studying whether the impact begins even earlier, such as in infancy, or whether intergenerational risks may play a role in a person's future brain health, Rovio said.
The research was published online May 10 in Circulation, the American Heart Association journal.
Dr. Thuy Bui is a pediatric emergency medicine physician for Children's Healthcare of Atlanta, in Georgia. She said, "I think we've known for a really long time that heart health and brain health are connected. Whether it's obesity, high blood pressure, diabetes, it just makes sense that the more of those effects that accumulate every time, the more it's going to affect your long-term health."
The COVID-19 pandemic may have thrown a lot of kids off because they couldn't do sports and activities they would normally do, she noted.
Bui said it's important to address healthy living while kids are young, including getting them involved in physical activity while finding ways to make exercise and healthy eating fun. She added that to make sure exercise has a place in her own life, she schedules it. And now her two teenagers join her on walks or runs, getting exercise for themselves, too.
It's not all about exercise and eating. If you have a lot of stress or experience depression, that can affect your heart and your brain, too, Bui said. It's important for people to take time for themselves and find ways to relieve stress, because that will also improve health and increase longevity.
"We talk about cardiovascular health and brain health, and we talk about it from a physical standpoint. I want people to also remember that behavioral health, mental health is a huge aspect to that," Bui said.
The Academy of Nutrition and Dietetics has more on helping kids eat healthy.
SOURCES: Juuso Hakala, MD, PhD student, Research Centre of Applied and Prevention Cardiovascular Medicine, University of Turku, Finland; Suvi Rovio, PhD, senior researcher, cardiovascular medicine and adjunct professor, department of clinical medicine, University of Turku, Finland; Thuy Bui, MD, pediatric emergency medicine physician, Children's Healthcare of Atlanta, and American Heart Association volunteer expert, youth programs; Circulation, May 10, 2021, online