Supplementary Material for: Association of Cardiovascular Health with Cognitive Function in U.S. Older Adults: a population-based cross-sectional study

Background: Promoting cardiovascular health (CVH) by Life’s Simple 7 is associated with better cognitive function. In 2022, the American Heart Association (AHA) prompted Life’s Essential 8 (LE8) to strengthen CVH assessment. This study investigated the association between the new CVH metrics assessed by LE8 and cognitive function, thus providing evidence for implementing LE8 in the primordial prevention of cognitive impairment. Method: 2050 participants aged 60 and older from National Health and Nutrition Examination Survey 2011-2014 were included. Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). The overall and domain-specific cognitive function z-score was created. CVH score was calculated following AHA’s advisory. The multivariable linear regression model estimated the associations. Results: The CVH score assessed by LE8 was independently, positively, and linearly associated with the overall cognitive function. A per-10 points increase in CVH was associated with higher overall cognitive z-scores (β, 0.06; 95% CI, 0.03, 0.09), and participants with moderate (β, -0.14; 95% CI, -0.22, -0.05) and low CVH (β, -0.27; 95% CI, -0.37, -0.16) had lower overall cognitive z-scores compared to participants with high CVH. Similar patterns of associations were observed between CVH of AFT and DSST. Components of CVH were further associated with different domain-specific cognitive functions. Conclusion: Maintaining an ideal CVH improves cognitive function in older adults. Ideal adherence to individual components of LE8 were associated with improved overall and domain-specific cognitive functions. Therefore, promoting CVH according to LE8 might benefit cognitive function in the elderly.