International journal of cardiology 2016 12 28() pii S0167-5273(16)32605-5
General cognitive ability (CA) is positively associated with later physical and mental health, health literacy, and longevity. We investigated whether CA estimated approximately 30years earlier in young adulthood predicted lifestyle-related risk factors and two-year survival in first myocardial infarction (MI) male patients.
Young adulthood CA estimated through psychometric testing at age 18-20years was obtained from the mandatory military conscript registry (INSARK) and linked to national quality registry SWEDEHEART/RIKS-HIA data on smoking, diabetes, hypertension, obesity (BMI>30kg/m(2)) in 60years or younger Swedish males with first MI. Patients were followed up in the Cause of Death registry. The 5659 complete cases (deceased=106, still alive=5553) were descriptively compared. Crude and adjusted associations were modelled with logistic regression.
After multivariable adjustment, one SD increase in CA was associated with a decreased odds ratio of being a current smoker (0.63 [0.59, 0.67], P<0.001), previous smoker (0.79 [0.73, 0.84], P<0.001), having diabetes (0.82 [0.74, 0.90], P<0.001), being obese (0.90 [0.84, 0.95], P<0.001) at hospital admission, and an increased odds ratio of two-year survival (1.26 [1.02, 1.54], P<0.001). CA was not associated with hypertension at hospital admission (1.03 [0.97, 1.10], P=0.283). CONCLUSIONS
This study found substantial inverse associations between young adulthood CA, and middle-age lifestyle risk factors smoking, diabetes, and obesity, and two-year survival in first MI male patients. CA assessment might benefit risk stratification and possibly aid further tailoring of secondary preventive strategy.